EDIS user guide - Veterans Affairs



Emergency Department Integration Software Version 1.0User GuideSeptember 2010Department of Veterans AffairsHealth Systems Design and Development VA Health Information TechnologyRevision HistoryThe revision-history cycle begins after the initial version of the user guide has been completed and approved .modeDatePatch or VersionDescriptionProject ManagerAuthorTable of Contents TOC \o "1-3" \h \z 1.Emergency Department Integration Software PAGEREF _Toc269300912 \h 11.1.About this Guide PAGEREF _Toc269300913 \h 11.2.Section 508 of the Rehabilitation Act of 1973 PAGEREF _Toc269300914 \h 21.2.1.Recommendations for JAWS Users PAGEREF _Toc269300915 \h 21.3.Role-based Access to Views PAGEREF _Toc269300916 \h 21.4.Document Conventions PAGEREF _Toc269300917 \h 31.5.Workstation Requirements PAGEREF _Toc269300918 \h 31.5.1.Flash Player: Minimum Requirements for Microsoft Windows PAGEREF _Toc269300919 \h 31.5.2.Flash Player: Minimum Requirements for Apple Mac OS PAGEREF _Toc269300920 \h 41.5.3.JAWS Workstation Requirements PAGEREF _Toc269300921 \h 41.6.Application Timeouts PAGEREF _Toc269300922 \h 51.7.Preventing Accidental Application Sign-Outs PAGEREF _Toc269300923 \h 52.Getting Started PAGEREF _Toc269300924 \h 72.1.Launch EDIS PAGEREF _Toc269300925 \h 72.2.Log In PAGEREF _Toc269300926 \h 72.2.1.Changing Your Verify Code PAGEREF _Toc269300927 \h 72.3.EDIS Views PAGEREF _Toc269300928 \h 82.3.1.Select a View PAGEREF _Toc269300929 \h 92.4.Work with Data Grids PAGEREF _Toc269300930 \h 92.4.1.Arrange Columns PAGEREF _Toc269300931 \h 92.4.2.Resize Columns PAGEREF _Toc269300932 \h 92.4.3.Sort Information within Columns PAGEREF _Toc269300933 \h 102.5.Access Help Files PAGEREF _Toc269300934 \h 102.6.Understanding EDIS and CPRS Interactions PAGEREF _Toc269300935 \h 102.7.Using EDIS with Appointment Management PAGEREF _Toc269300936 \h 112.7.1.Benefits of this Method PAGEREF _Toc269300937 \h 112.7.2.Drawbacks of this Method PAGEREF _Toc269300938 \h 112.7.3.Best Practice for Using EDIS with Appointment Management PAGEREF _Toc269300939 \h 112.7.4.Processes with Unscheduled Appointments (in Appointment Management) that Lead to Errors PAGEREF _Toc269300940 \h 112.8.Using EDIS with PCE PAGEREF _Toc269300941 \h 122.8.1.Benefits of this Method PAGEREF _Toc269300942 \h 122.8.2.Drawbacks of this Method PAGEREF _Toc269300943 \h 122.8.3.Best Practice for Using EDIS with PCE PAGEREF _Toc269300944 \h 122.8.4.Why this Is Best Practice PAGEREF _Toc269300945 \h 132.8.5.Processes with PCE that Lead to Errors PAGEREF _Toc269300946 \h 133.Notifications PAGEREF _Toc269300947 \h 153.1.Patient-Selection Messages PAGEREF _Toc269300948 \h 154.Sign In View PAGEREF _Toc269300949 \h 174.1.Add Patients to EDIS from the Sign In View PAGEREF _Toc269300950 \h 174.1.1.Adding Patients Using the Search for Patient in VistA Selection PAGEREF _Toc269300951 \h 184.1.2.Adding Patients Using the Enter Name Selection PAGEREF _Toc269300952 \h 184.1.3.Adding Patients Using the Ambulance Is Arriving Selection PAGEREF _Toc269300953 \h 194.1.4.Add Information to the Patient Information Pane PAGEREF _Toc269300954 \h 194.1.5.Definitions for Nationally Released Source Selections PAGEREF _Toc269300955 \h 205.Identify Patients PAGEREF _Toc269300956 \h 215.1.Identifying Patients PAGEREF _Toc269300957 \h 226.Triage View PAGEREF _Toc269300958 \h 236.1.Add Patients to EDIS from the Triage View PAGEREF _Toc269300959 \h 246.1.1.Adding Patients Using the Search for Patient in VistA Selection PAGEREF _Toc269300960 \h 246.1.2.Adding Patients Using the Enter Name Selection PAGEREF _Toc269300961 \h 256.1.3.Adding Patients Using the Ambulance Is Arriving Selection PAGEREF _Toc269300962 \h 266.2.Add Triage Information PAGEREF _Toc269300963 \h 286.2.1.Definitions for Status Selections PAGEREF _Toc269300964 \h 296.3.Create a Visit in CPRS PAGEREF _Toc269300965 \h 297.Update View PAGEREF _Toc269300966 \h 317.1.Add or Update Information in the Patient Information Pane PAGEREF _Toc269300967 \h 317.2.Create a Visit PAGEREF _Toc269300968 \h 327.2.1.Setting a Primary Provider for Your Patient’s Visit PAGEREF _Toc269300969 \h 328.Disposition View PAGEREF _Toc269300970 \h 338.1.Select a Disposition PAGEREF _Toc269300971 \h 348.1.1.Definitions for National Dispositions PAGEREF _Toc269300972 \h 348.2.Select a Reason for Delay PAGEREF _Toc269300973 \h 358.2.1.Definitions for National Reason-for-Delay Selections PAGEREF _Toc269300974 \h 358.3.Enter ICD-9-CM Diagnoses PAGEREF _Toc269300975 \h 388.4.Enter Free-Text Diagnoses PAGEREF _Toc269300976 \h 388.5.Remove Patients PAGEREF _Toc269300977 \h 398.6.Remove Patients Entered in Error PAGEREF _Toc269300978 \h 409.Edit Closed View PAGEREF _Toc269300979 \h 4110.Display Board View PAGEREF _Toc269300980 \h 4310.1.Viewing the Display Board PAGEREF _Toc269300981 \h 4311.Assign Staff View PAGEREF _Toc269300982 \h 4511.1.Add Providers, Residents, and Nurses PAGEREF _Toc269300983 \h 4511.2.Remove Providers, Residents, and Nurses PAGEREF _Toc269300984 \h 4611.3.Configure Colors for Providers, Residents, and Nurses PAGEREF _Toc269300985 \h 4612.Reports View PAGEREF _Toc269300986 \h 4712.1.Eleven Standard Reports PAGEREF _Toc269300987 \h 4712.1.1.Column Headings PAGEREF _Toc269300988 \h 4712.1.2.Standard Reports PAGEREF _Toc269300989 \h 4812.1.3.Cross Reference and Provider Reports PAGEREF _Toc269300990 \h 5712.2.Run and View Reports PAGEREF _Toc269300991 \h 5912.2.1.Print Reports PAGEREF _Toc269300992 \h 6012.2.2.Export Reports PAGEREF _Toc269300993 \h 6013.Configure View PAGEREF _Toc269300994 \h 6213.1.Room and Area Configurations PAGEREF _Toc269300995 \h 6213.1.1.Add, Configure, and Edit Rooms and Areas PAGEREF _Toc269300996 \h 6213.2.Display Board Configurations PAGEREF _Toc269300997 \h 6513.2.1.Add a New Display Board PAGEREF _Toc269300998 \h 6513.2.2.Add Display Board Columns PAGEREF _Toc269300999 \h 6613.2.3.Configure or Edit Display Board Columns PAGEREF _Toc269301000 \h 6813.2.4.Specify the Order of Display Board Columns PAGEREF _Toc269301001 \h 6813.2.5.Resize Display Board Columns PAGEREF _Toc269301002 \h 6913.2.6.Remove Display Board Columns PAGEREF _Toc269301003 \h 6913.2.7.Save Display Board Configuration Changes PAGEREF _Toc269301004 \h 6913.3.Configure Colors PAGEREF _Toc269301005 \h 7013.3.1.Configure Colors (General Instructions) PAGEREF _Toc269301006 \h 7013.3.2.Configure Colors for Status and Acuity Values PAGEREF _Toc269301007 \h 7113.3.3.Configure Colors for Urgency – Lab Values PAGEREF _Toc269301008 \h 7213.3.4.Configure Colors for Urgency – Radiology Values PAGEREF _Toc269301009 \h 7313.3.5.Configure Colors for Total Elapsed Minutes PAGEREF _Toc269301010 \h 7413.3.6.Configure Colors for Minutes at Location PAGEREF _Toc269301011 \h 7513.3.7.Configure Colors for Minutes for Lab Order PAGEREF _Toc269301012 \h 7613.3.8.Configure Colors for Minutes for Imaging Order PAGEREF _Toc269301013 \h 7713.3.9.Configure Colors for Minutes for Unverified Orders PAGEREF _Toc269301014 \h 7813.4.Configure Parameters PAGEREF _Toc269301015 \h 7913.4.1.Include Residents on Entry Form PAGEREF _Toc269301016 \h 8013.4.2.Require a Diagnosis PAGEREF _Toc269301017 \h 8013.4.3.Require ICD-9-CM or Free Text Diagnoses PAGEREF _Toc269301018 \h 8013.4.4.Require Disposition to Remove Patients PAGEREF _Toc269301019 \h 8013.4.5.Require a Reason for Delay PAGEREF _Toc269301020 \h 8113.4.6.Configure Shift Parameters PAGEREF _Toc269301021 \h 8113.4.7.Set a Default Room or Area for Patients Arriving by Ambulance PAGEREF _Toc269301022 \h 8113.4.8.Set a Default Room or Area PAGEREF _Toc269301023 \h 8113.4.9.Save Parameter Selections PAGEREF _Toc269301024 \h 8113.5.Add Choices to Selection Lists PAGEREF _Toc269301025 \h 8213.5.1.Add Status, Disposition, Delay Reason, and Source Selections PAGEREF _Toc269301026 \h 8314.Index PAGEREF _Toc269301027 \h 85Emergency Department Integration Software Emergency Department Integration Software (EDIS) incorporates several Web-based views that extend the current Computerized Patient Record System (CPRS) to help healthcare professionals track and manage the flow of patient care in the emergency-department setting. EDIS views are based on a class-three application developed by the Upstate New York Veterans Health Care Network—or Veterans Integrated Services Network (VISN) 2. Most views are site configurable. EDIS enables you to: Add emergency-department patients to the application’s display boardView information about patients on the display boardEdit patient informationRemove patients from the display boardCreate administrative reports The application also includes views for entering patients’ dispositions, removing patients from the display board, and configuring the display board.About this GuideThis guide steps you through the process of performing the following tasks:Launch Emergency Department Integration Software (EDIS)Sign in patients to the emergency department (when you use the VistA Scheduling package (also known as Appointment Manager) to make appointments for—or check patients into—the emergency department, EDIS automatically adds the patients to its Active Patients list)Enter Emergency Severity Index (ESI) values for triaged patientsCreate emergency-department visits in the CPRS Patient Care Encounters (PCE) package (if not using Appointment Manager)Update patient information as patients progress through the emergency-care processView the display boardEnter patients’ dispositions in EDIS Enter patients’ discharge diagnoses in EDIS and CPRSRemove patients from the display board (this task incorporates disposing patients, which supports discharge and admit processes)Make site- and shift-relevant staff assignmentsEdit visit-related information Create reportsConfigure the application using its graphical user interface (GUI) toolsFigure 1: EDIS user interface. XE "Rehabilitation Act of 1973 (Section 508):Job Access with Speech (JAWS)" XE "JAWS (Job Access with Speech)" Section 508 of the Rehabilitation Act of 1973 The Portable Document File (PDF) version of this guide supports assistive reading devices such as Job Access with Speech (JAWS). Because the views that comprise EDIS provide graphical user interface (GUI) access to underlying functionality, the guide includes steps for accessing application functionality via mouse devices and keyboard actions (when keyboard actions are available). XE "JAWS (Job Access with Speech:Recommendations for JAWS users" Recommendations for JAWS UsersTo effectively use EDIS with JAWS, the EDIS project team offers the following recommendations:Use JAWS 10.Use JAWS forms mode; most functions work best in Forms mode.In JAWS 10, use JAWS Verbosity settings to turn off Autoforms mode.Make sure the latest Flex scripts are installed on your machine. (You can download JAWS scripts for Flex 3—an executable file—at .)Flex applications behave a bit differently than do regular Web applications—a result of the way Flash and Flex interact with browsers and JAWS screen readers. JAWS, Flex, and EDIS work together best with IE 6.0. (Testers experienced a few problems with IE 7.0 and Firefox.) Regardless of which browser you use, you can expect a slight learning curve. XE "Role-based access" \t "See Views" Role-based Access to ViewsEDIS provides role-based access to the specific functionality sets that are available through its views. If the application does not display in its left-hand menu pane, one or more of the views this guide describes, your current role may not be compatible with functionality that the views include. Please contact your information resource management (IRM) or clinical application coordinator (CAC) staff if you have questions about your role. Please see Emergency Department Integration Software Technical Manual—M Server for information about configuring role-based access to application functionality. Document ConventionsBold type indicates application elements (views, panes, links, buttons, and text boxes, for example) and key names. Key names appear in angle brackets <>. Italicized text indicates special emphasis.The warning icon () indicates items of particular importance.Within the confines of this user guide, the terms visit and encounter are synonymous. XE "Requirements:Workstation" XE "Workstation requirements" Workstation RequirementsEDIS runs in XE "Adobe Flash Player" Adobe Flash Player, which in turn runs in a Web browser. If you do not have Flash Player 9.0 or above installed on your computer, EDIS will prompt you to download and install it. Installation requires administrator access to your machine; you may need assistance from an IT representative at your site. XE "Requirements:Browser requirements for Flash Player" Flash Player: Minimum Requirements for Microsoft Windows Intel Pentium II 450MHz or faster processor (or equivalent), AMD Athlon 600MHz or faster processor (or equivalent) 128MB RAMBrowsers:Browser Requirements for Flash Player 9.xPlatformBrowserWindows VistaInternet Explorer 7, Firefox 2.0, AOL 9Windows XPInternet Explorer 6.0 or later, Firefox 1.x, Firefox 2.x, Mozilla 1.x or later, Netscape 7.x or later, AOL 9, Opera 7.11 or laterWindows Server 2003Internet Explorer 6.0 or later, Firefox 1.x, Firefox 2.xWindows 2000Internet Explorer 5.x, Firefox 1.x, Firefox 2.x, Mozilla 1.x, Netscape 7.x or later, AOL 9, Opera 7.11 or laterWindows Millennium EditionInternet Explorer 5.5, Firefox 1.x, Mozilla 1.x, Netscape 7.x or later, AOL 9, Opera 7.11 or laterWindows 98Internet Explorer 6.0 or later, Firefox 1.x, Mozilla 1.x, Netscape 7.x or later, Opera 7.11 or laterBrowser Requirements for Flash Player 10.xPlatformBrowserWindows VistaMicrosoft Internet Explorer 7.0 or later, Firefox 2.x, Firefox 3.x, AOL 9, Safari 3.xWindows XPMicrosoft Internet Explorer 6.0 or later, Firefox 2.x, Firefox 3.x, AOL 9, Opera 9.5 or later, Safari 3.xWindows Server 2003Microsoft Internet Explorer 6.0 or later, Firefox 2.x, Firefox 3.xWindows 2000Internet Explorer 5.x, Firefox 1.x, Firefox 2.x, Mozilla 1.x, Netscape 7.x or later, AOL 9, Opera 7.11 or laterWindows Server 2008Internet Explorer 7.0 or later, Firefox 3.xWindows 2000Internet Explorer 6.0, Firefox 2.x, Firefox 3.x, AOL 9, Opera 9.5 XE "Requirements:Flash Player minimum requirements for Apple Mac OS" Flash Player: Minimum Requirements for Apple Mac OSPowerPC G3 500MHz or faster processor or Intel Core Duo 1.33GHz or faster processor128MB RAMBrowsers:Browser Requirements for Flash Player 9.xPlatformBrowserMac OS X 10.1 or later(PowerPC)Firefox 1.x, Mozilla 1.x, Netscape 7.x or later, AOL for Mac OS X, Opera 6, Safari 1.x or laterMac OS X 10.4.x or later (Intel)Firefox 1.5.0.3 or later, Opera 6, Safari 2.x or laterBrowser Requirements for Flash Player 10.xPlatformBrowserMac OS X 10.4 or 10.5(PowerPC)Firefox 2.x, Firefox 3.x, AOL for Mac OS X, Opera 9.5, Safari 3.xMac OS X 10.4.x or 10.5 (Intel)Firefox 2.x, Firefox 3.x, Opera 9.5, Safari 3.x XE "Requirements: Job Access with Speech workstation requirements" JAWS Workstation RequirementsIf you are a JAWS user, you or your site’s IRM staff must download and install Adobe Flex accessibility scripts. To download JAWS scripts for Flex 3, go to . Click the executable file to install the scripts on your machine. These scripts work for JAWS 9 and 10; however, the EDIS project team recommends that you use JAWS 10 for the best results with EDIS. Flex applications behave a bit differently than do regular Web applications—a result of the way Flash and Flex interact with browsers and JAWS screen readers. JAWS, Flex, and EDIS work together best with IE 6.0. (Testers experienced a few problems with IE 7.0 and Firefox.) Regardless of which browser you use, you can expect a slight learning curve. JAWS 10 users must turn off Autoforms mode (use the JAWS Verbosity settings). XE "Application timeouts" Application Timeouts EDIS uses the same parameter settings that CPRS uses for application timeouts and timeout countdowns: namely, ORWOR TIMEOUT CHART and ORWOR TIMEOUT COUNTDOWN settings. IRM personnel enter values for these parameters at the site level. Emergency-department managers usually do not determine them. For many sites, EDIS and CPRS are set to time out after 15 minutes of inactivity. If the ORWOR TIMEOUT CHART parameter contains a value, this value determines the amount of time that EDIS can sit idle before it displays a timeout warning and begins its countdown. (The ORWOR TIMEOUT CHART parameter supports a maximum timeout value of 2147483 seconds. Sites can determine local timeout values that are smaller than or equal to this maximum value.) If the ORWOR TIMEOUT CHART parameter contains no value, EDIS uses the value of the Timed Read (DTIME) parameter, which is available through VistA’s user setup menu. The value of the ORWOR TIMEOUT COUNTDOWN setting determines the length of the application’s timeout countdown. EDIS displays its timeout message and countdown within the browser, at the bottom of the current EDIS view. Because JAWS cannot read this message, EDIS also sounds a chime as it begins its timeout countdown.Figure 2: The EDIS timeout warning and countdown.If users are simultaneously running CPRS and EDIS, an active CPRS window can obscure the EDIS timeout warning and countdown. In high-use situations—in triage areas where several users share a single instance of CPRS and EDIS, for example—facilities may want to consider using separate screens for each application. This solution helps ensure that both applications are fully visible. XE " Preventing EDIS from accidentally closing " Preventing Accidental Application Sign-OutsEDIS may automatically sign you out when you launch other Web applications—such as UpToDate—while it is running. You can prevent this from happening by cancelling the selection of Internet Explorer’s Reuse windows for launching shortcuts setting. The following fix-it-yourself solution should be available to all users (administrative access is not required). Launch Internet Explorer and click Tools on the main menu.Select Internet Options. Select the Advanced tab in the Internet Options dialog box. In the Browsing list, find the Reuse windows for launching shortcuts or (depending on the version of Internet Explorer you are using) Reuse windows for launching shortcuts (when tabbed browsing is off) setting.If this setting is selected, click the checkbox to cancel the selection. Figure 3: The Internet Options dialog box, Advanced tab, Browsing list. Getting Started XE "Launch EDIS" Launch EDIS If your IRM or CAC staff hasn’t provided a desktop shortcut or added an EDIS link to your CPRS Tools menu, you can access EDIS by pointing your browser to REDACTED—the application’s Uniform Resource Locater (URL). If you want to access the application’s main electronic whiteboard (or big-board) display, use the following URL: REDACTED. If you want to access a secondary big-board display, use this URL:REDACTED. (Replace [boardname] with the name of the display board you want to view.) When you access these URLs, the application's security system automatically redirects you to the login page. As it does this, the security system begins its authentication process. XE "Adding EDIS to IE Favorites" Adding EDIS to your Internet Explorer Favorites If you bookmark the EDIS login page, the link you initially create will bypass the application’s redirection-authentication process and the application’s security system will deny you access. You can remedy this situation by editing your bookmark link. In Internet Explorer, right-click the EDIS login bookmark and select Properties. Edit the URL field to contain either REDACTED or REDACTEDClick OK.You can also create desktop shortcuts using these URLs. XE "Log in" Log InWhen you launch EDIS, the application displays a login view that uses credentials stored in your local VistA system. To log in:Type your VistA access and verify codes in the Access Code and Verify Code boxes, respectively. Select your site in the Institution list. EDIS uses a persistent cookie to preselect your site upon subsequent logins, but only on the specific machine you used when you made this selection. You must select your site from the Institution list each time you use a new computer. (Your site may have configured a desktop shortcut that eliminates the need for this step by preselecting your institution.) Failure to select the correct institution is the most common cause of unsuccessful login attempts.Click Login or press the <Enter> key. XE "Verify code (change)" Changing Your Verify CodeFor user authentication, EDIS relies on Kernel Authentication and Authorization for Java 2 Enterprise Edition (KAAJEE)—which is the only VA-approved login security package. KAAJEE limitations prevent EDIS from offering functionality that allows you to change your verify code within the EDIS application. When your VistA verify code expires, you can change it in CPRS or another VistA application. EDIS will then accept the change. XE "Views" EDIS ViewsFollowing is a list and brief explanation of each view. Not all views are available to all users. EDIS offers site-configurable, role-based access to views. If you do not have access to a view that you need, speak with the IRM or CAC staff responsible for role-based access at your site. XE "Sign In view" XE "Views:Sign In" Sign InThe Sign In view enables you to add patients to the application and the display board. This view also allows you to add for-display complaints, assign rooms or areas, and select patients’ sources (the places from which patients have come—onsite clinics or offsite nursing homes, for example). XE "Triage view" XE "Views:Triage" TriageThe Triage view enables you to add patients to the display board; add their acuity, nurse, provider, and resident assignments; specify the clinic location that EDIS will use to create PCE visits (if applicable); and add or update patients’ source and room or area assignments. XE "Update view" XE "Views:Update" UpdateThe Update view enables you to add patients’ status information and comments that the application does not display on the display board. You can also add or update physician, resident, nurse, and room or area assignments. XE "Views:Disposition" XE "Disposition view" DispositionThe Disposition view enables you to enter patients’ dispositions and diagnoses (either International Classification of Diseases, Ninth Revision, Clinical Modifications [ICD-9-CM] or free-text, if the system administrator allows free-text entries). If patients’ stays have exceeded the national emergency-department visit limit (currently six hours), the application may require you to select a reason for delay. If it does, this view will include a list of reasons from which you can choose. You can also add or update patients’ status and provider and resident assignments from this view. XE "Views:Edit Closed" XE "Edit Closed view" Edit ClosedThe Edit Closed view enables you to edit patients’ information after their emergency-department visits have ended. XE "Views:Display Board" XE "Display Board view" Display BoardThe Display Board view is a PC-based version of your site’s main electronic white-board—or big-board—display. You can configure multiple big-board displays for your site. However, you can view only your site’s main display board using the PC-based Display Board view. XE "Views:Assign Staff" XE "Assign Staff view" Assign StaffThe Assign Staff view enables you to create site-specific staff-selection lists. You can also use this view to assign color indicators for individual staff members. XE "Views:Reports" XE "Reports view" ReportsThe Reports view enables you to select date ranges for, and run, 11 standard reports. EDIS also includes two restricted reports that require security-key access. XE "Views:Configure" XE "Configure view" ConfigureThe Configure view enables you to localize the tracking application. For example, it enables you to assign locally meaningful color codes for patients’ acuities and statuses, populate pick lists with the names of your site’s treatment areas, set up display boards that contain only relevant information, and more. XE "Selecting views" Select a ViewClick the view you want to access on the left-hand view-selection menu. This menu is available from all application views. Keyboard: use the <Tab> key to locate the left-hand view-selection menu. Use the <Down Arrow> and <Up Arrow> keys to locate the view you want to select. Use the <Spacebar> key to select the view. XE "Data grids" Work with Data GridsEDIS commonly displays information using a tabular—or grid—format. The application’s data grids allow you to: Arrange columnsResize columnsSort within columnsThe results of these actions are temporary. EDIS does not retain data-grid changes. XE "Arrange columns" XE "Data grids:Arrange columns" Arrange ColumnsPerform a drag-and-drop operation:Point to a column header and hold down the left mouse button.Still holding down the left mouse button, move the column header to a new location. Release the left mouse button. XE "Resize columns" XE "Data grids:Resize columns" Resize ColumnsPerform a drag-and-drop operation:Point your mouse to a column boarder in the header row. EDIS displays a column slider in place of the pointer. Hold down the left mouse button and move the boarder to a new location.Release the left mouse button.Figure 4: The slider for resizing columns. XE "Sort columns" XE "Data grids:Sort columns" Sort Information within ColumnsYou can sort the information within most columns.Click a column header to sort the information within the column in descending order. Click the column header again to sort the column’s contents in ascending order. Figure 5: Sort information within columns by clicking on column headers. XE "Help files" Access Help FilesClick the Help button to access view-specific Help files. Keyboard: use the <Tab> key to locate the Help button and use the <Spacebar> key to select the button.Figure 6: The Help button is located in the right-hand corner of the application’s title bar. XE "EDIS and CPRS interactions" XE "Integrating via Appointment Manager" XE "Integrating via PCE" Understanding EDIS and CPRS InteractionsYou can successfully integrate CPRS with EDIS in one of two ways:Create an unscheduled appointment in Appointment Management; when you create an unscheduled appointment for a clinic location your site has specified in the EDPF LOCATION parameter, EDIS adds the patient to the EDIS Active Patients list. Create an unscheduled visit (encounter) via patient care encounters (PCE). Each method has strengths and weaknesses. As is the case for any patient-scheduling system, less-than-optimal practices can lead to duplicated encounters. Sections 2.7 and 2.8 provide information that may help you choose the method that’s best for your location. Please read these two sections carefully. XE " EDIS integration via Appointment Manager " Using EDIS with Appointment ManagementBenefits of this MethodYour site maintains the advantage of having a selectable list of triaged emergency-department patients available on the CPRS Patient Selection view. This list of scheduled (that is, Appointment Management-created) appointments is not available via the PCE method. Drawbacks of this MethodSuccessful CPRS and EDIS integration using this method requires intensive (recommended twenty-four-hours a day, seven days a week—or 24x7) secretarial and administrative support. For this method to work, your site must create an appointment for each emergency-department patient before doing anything else–which requires round-the-clock support of administrative staff who have access to Appointment Management.Best Practice for Using EDIS with Appointment ManagementAdd Patients to Appointment Management First:When a patient presents to the emergency department for evaluation, a member of your site’s administrative staff immediately creates an appointment for the patient in Appointment Management. This creates a selectable visit in CPRS and adds the patient to EDIS. The triage nurse must subsequently add additional data to EDIS. EXAMPLE:Ms. Jones arrives at 11:30.At 11:32, a member of the administrative staff uses Appointment Management to create an appointment for Ms. Jones. EDIS automatically displays Ms. Jones on its Active Patients list.The triage nurse sees Ms. Jones at 11:35 and completes her EDIS triage information; the nurse then opens CPRS and writes a triage note under the visit in CPRS that corresponds to Ms. Jones’s emergency-department appointment. The emergency-department provider selects this same visit in CPRS when he or she writes notes or orders related to Ms. Jones’s emergency-department care.Why this Is Best PracticeCPRS was created long before EDIS. It has not been changed to recognize that EDIS exists. Processes with Unscheduled Appointments (in Appointment Management) that Lead to ErrorsThe following list contains things you should not do. We have included this section to help you troubleshoot problems that can occur when your site uses EDIS with unscheduled appointments in Appointment Management. Creating unscheduled appoints just before the midnight hour: Appointments will disappear at midnight for patients who have unscheduled appointments for times that precede the midnight hour and for whom emergency-department personnel have completed neither documentation nor orders before midnight. When this occurs, your site must reenter the vanished appointments, thus creating both second appointments and duplicate PCE encounters. This problem is the result of CPRS business logic, which exists outside of EDIS.Failing to select the proper appointment when writing notes or ordering tests:Providers and nurses create duplicate PCE encounters if they fail to select the proper appointment in CPRS when writing notes or ordering tests. Writing notes or orders before creating unscheduled appointments:Providers and nurses create duplicate PCE encounters when they write orders or notes before administrative personnel have created unscheduled appointments for their patients. XE " EDIS integration via PCE " Using EDIS with PCE Benefits of this MethodIntegrating EDIS with CPRS via PCE does not require intensive (recommended 24x7) support from personnel who have access to Appointment Management. (The Appointment Management method requires sites to create appointments for patients before doing anything else, which in turn requires round-the-clock support from administrative personnel who have access to Appointment Management.) Drawbacks of this MethodWhen sites switch from using Appointment Management to PCE, their users no longer have a list on their Patient Selection (initial) view of CPRS from which they can select patients who have emergency-department appointments. This list of scheduled (that is, Appointment Management-created) appointments only appears when sites use the Appointment Management method. As a result of not having this list, looking up patients who were discharged in the past (days or weeks ago) is a little more difficult in CPRS. However, authorized users can easily look up these patients in the EDIS Edit Closed view. Best Practice for Using EDIS with PCEPlace Patient on EDIS First with Provider Name:When a patient presents to the emergency department for evaluation, someone notifies the triage nurse and adds the patient to EDIS. The person who adds the patient to EDIS must also add a provider name at this step. Assigning a provider in EDIS creates an unscheduled visit (encounter) in CPRS. Providers and nurses can subsequently write their notes and orders under this visit. Although assigning a nurse in EDIS can also generate a visit in CPRS, it doesn’t always. Nurse assignments generate selectable visits in CPRS only if your hospital configures nurses with an active person class in VistA’s New Person file. Some sites do not allow this practice. In addition, using nursing assignments to create PCE visits makes nurses primary providers in EDIS-generated encounters. Primary providers must change these placeholder assignments for visits other than nursing-only visits. To do this, primary providers should select Yes when CPRS prompts them to identify themselves as primary providers for encounters they are signing.EXAMPLE #1:At 11:31, a member of the administrative staff or a triage nurse adds Mr. Jones to EDIS and assigns Dr. Smith as Mr. Jones’s provider.This creates an 11:31 visit (encounter) for Mr. Jones in CPRS.The triage nurse opens CPRS, enters Mr. Jones’s chart, starts note, and selects the emergency-department visit that already appears in CPRS.The triage nurse writes and signs the note.Mr. Jones’s provider writes a note or orders, also selecting the visit that EDIS already created in CPRS. In this example, if the initially assigned provider is not the primary provider for the visit, the primary provider must select himself or herself when he or she signs the note. Someone (the provider, a clerk, or another emergency-department staff member) must also update EDIS to reflect the correct primary provider. EXAMPLE #2:At 11:31, an LPN adds Mr. Jones to EDIS.Mr. Jones’s triage nurse has an active person class in VistA’s New Person file and opens a PCE encounter for Mr. Jones’s visit in CPRS as a provider.A provider sees Mr. Jones; the provider (or a charge nurse or clerk) adds the provider’s name in EDIS. When he is signing the encounter in CPRS, the provider identifies himself as the primary provider for the encounter. Had no primary provider seen Mr. Jones (if he had left without being seen, for example) the triage nurse would close the encounter as a nurse-only visit. Why this Is Best PracticeCPRS was created long before EDIS and has not been updated to recognize that EDIS exists. The PCE system is limited—it cannot create visits unless users enter primary providers or diagnoses for the encounters. If users add patients to EDIS without selecting their primary providers or diagnoses, EDIS cannot give to CPRS the information that CPRS must supply to the PCE application, and PCE cannot create the encounters. This is a limitation of the PCE application, not a limitation of EDIS. Because diagnoses are rarely available early in the patient-care process, the best practice is to select a provider when you add a patient to EDIS. When patients present before midnight but providers do not treat them until after midnight, the providers must be certain to select the EDIS-created visit from the preceding day, as opposed to opening new (duplicate) visits. Processes with PCE that Lead to ErrorsThe following list contains things you should not do. We have included this section to help you troubleshoot problems that can occur when your site uses EDIS with the PCE system. Failing to select a provider when adding a patient to EDIS: When you fail to select a provider, EDIS cannot create a visit (encounter) in CPRS.Failing to add a patient upon his or her arrival:Duplicate encounters will result if users fail to add patients to EDIS (and select a provider) until after clinicians have started writing notes or orders.Failing to select the EDIS-created visit when starting notes or writing orders:Duplicate encounters will result if nurses and providers fail to select the visit EDIS creates when they start notes or create orders. Continuing to use Appointment Management for some patients: Implementing two separate process flows can confuse staff and lead to errors. XE "Notifications" \t "See also: Alerts" Notifications XE "Notifications:Patient selection messages" Patient-Selection MessagesWhen you select patients who are already registered in your local VistA system, EDIS may display one or more of the following messages: XE "Restricted record warning" Restricted Record Warning: this message appears when you select a patient whose records contain sensitive information. Only authorized users may view these records. Figure 7: Restricted Record warning (sensitive patient data). XE "Notifications:Patient record flags" Patient Record Flags: EDIS displays these advisory messages when you add patients whose records are flagged in VistA. You can view patient record flags after you’ve added patients by clicking the Flag button, which appears on the Patient Information bar when you select the Sign In, Triage, Update, Disposition, or Edit Closed view. When you click the Flag button, EDIS displays important information to help you and other clinical staff better care for patients whose behavior or medical conditions warrant special attention. The application displays patient-record flags in the Active Flag window. Figure 8: The Active Flag window. XE "Notifications:Duplicate patient selection warning" Duplicate Selection: EDIS displays this advisory when you attempt to add patients who are already active in the application. Figure 9: The Duplicate Selection warning. XE "Notifications: Multiple patient icon" Multiple Patient icon: the application alerts you to the possibility of confusing patients’ identities by displaying an icon () when two or more patients share the same last name or at least two consecutive ending digits of their social security numbers. XE "Sign In view" Sign In ViewEDIS automatically adds patients when you use VistA’s Scheduling (Appointment Management) package to create an emergency department appointment for patients. The EDPF LOCATION parameter, which holds your site’s emergency department location or locations, controls this functionality. Parameter settings ensure that only emergency-department check-ins and appointments add patients to EDIS. You can also add patients to the application from its Sign In and Triage views. XE "Sign In view:Add patients" Add Patients to EDIS from the Sign In View Figure 10: The Add Patient dialog box.Click Add Patient in the upper right-hand corner of the Active Patients list. Keyboard: use the <Tab> key to locate the Add Patient button and press the <Spacebar> key to select it. The application displays the Add Patient dialog box, which offers the following three selections: Search for Patient in VistA: enables you to add patients who are already in your local VistA system Ambulance Is Arriving, Patient Name Is Unknown: enables you to add information for patients whose identities are unknown (EDIS does not create PCE visits for these patients until someone adds them via a VistA search)Enter Name, Patient Is Not in VistA enables you to add patients who are not in your local VistA system (EDIS does not create PCE visits for these patients until someone adds them via a VistA search) EDIS does not activate the Add Patient button when you are already in the process of signing in a patient. To activate the Add Patient button in this case, you must click Save to complete the sign-in process for the current patient or Cancel to cancel the process and discard the information you’ve entered. XE "Add patient:Search for Patient in VistA" Adding Patients Using the Search for Patient in VistA SelectionIf necessary, select Search for Patient in VistA. (Search for Patient in VistA is the application’s default selection; in most cases, you won’t need to manually select this button.) Keyboard: if the Search for Patient in VistA button isn’t already selected, use the <Tab> key to locate the selected button (Enter Name, Patient Is Not in VistA or Ambulance Is Arriving, Patient Name Is Unknown). Use the <Up Arrow> key to locate the Search for Patient in VistA button and use the <Spacebar> key to select it. Type all or part of the patient’s name in the Find Patient box using this format: Surname,Firstname. For example, you can search using the patient’s surname only, or the patient’s surname and the first initial of his or her first name. You can also search using the initial letter of the patient’s surname concatenated with the last four digits of his or her Social Security number (X9999 format), the patient’s entire Social Security number (SSN), or the last four digits of his or her SSN.Use an underscore to denote spaces in names. For example, if the patient’s name is O Hara, type O_Hara. Click Search or press the <Enter> key. The Add Patient dialog box lists possible matches. Select the correct patient and click Continue or press the <Enter> key. Keyboard: use the <Down Arrow> and <Up Arrow> keys to locate the correct patient. Press the <Enter> key to select the patient or use the <Tab> key to locate the Continue button and then press the <Spacebar> key to select it. The application displays the Patient Information pane. XE "Add patient: Enter Name, Patient Is Not in VistA" Adding Patients Using the Enter Name Selection If the Find Patient search list does not contain a match, add the patient using the Enter Name, Patient Is Not in VistA selection.In the Add Patient dialog box, select Enter Name, Patient Is Not in VistA. Keyboard: use the <Tab> key to locate the currently selected button and use the <Down Arrow> or <Up Arrow> key to locate the Enter Name, Patient Is Not in VistA button. Press the <Spacebar> key to select this button. EDIS automatically populates the Patient Name box with the name you typed to initiate the VistA search. If this name is incorrect or incomplete, type the patient’s full name in the Patient Name box using this format: Lastname,Firstname. Keyboard: use the <Tab> key to locate the Patient Name box. Press the <Enter> key or click Continue. The application displays the Patient Information pane. XE "Add patient:Adding unidentified patients" Adding Unidentified PatientsWhen you must add unresponsive patients whose identities you do not know, use the Enter Name, Patient Is Not in VistA selection and follow the naming protocol defined in section 12 of VHA Directive 2006-036: Data Quality Requirements for Identity Management and Master Patient Index Functions. (Use the name UU-UNRESPONSIVE,PATIENT for the first such patient, UU-UNRESPONSIVE,PATIENT A for the second, UU-UNRESPONSIVE,PATIENT B for the third, and so forth. You can find the full text of this directive at REDACTED XE "Add patient:Ambulance Is Arriving, Patient Name Is Unknown" Adding Patients Using the Ambulance Is Arriving SelectionEDIS enables you to add unknown patients who are arriving by ambulance or other types of emergency transportation, thereby allowing you to make room, provider, and nurse assignments before these patients arrive. Select Ambulance Is Arriving, Patient Name Is Unknown. Keyboard: use the <Tab> key to locate the currently selected button, and use the <Down Arrow> key to locate the Ambulance Is Arriving, Patient Name Is Unknown button. Press the <Spacebar> key to select this button.Click Continue. Keyboard: use the <Tab> key to locate the Continue button and use the <Spacebar> key to select it. The application displays the Patient Information pane.EDIS reports do not reflect the number of patients whom users add to the application via this method. Also, EDIS creates its Time In timestamps when users identify patients in VistA or create unscheduled appointments for them in Appointment Management. As a result, sites must correct EDIS’s Time In values to reflect the times these patients actually arrived at the emergency department. XE "Add patient:Add information to the Patient Information pane " Add Information to the Patient Information PaneIn the Complaint for Display Board box, type the complaint you want the application to present on the big board display. This information is mandatory; you must type a complaint in this box or the application will not add your patient. The box accepts up to 50 characters. Keyboard: press the <Tab> key to locate the Complaint for Display Board box.Open the Room / Area list. Select a room or area. Room or area information is mandatory. The application’s default selection is the waiting room. Keyboard: use the <Tab> key to locate the Room / Area list and use the <Down Arrow> and <Up Arrow> keys to select a room or area from the list. Open the Source list and select the source of the patient’s emergency-department visit—an offsite clinic, for example. (Definitions for nationally released sources are available in section 4.1.5 of this guide.) Keyboard: use the <Tab> key to locate the Source list and use the <Down Arrow> and <Up Arrow> keys to select a source from the list. Click Save to save the patient’s sign-in information and add him or her to the display board.-or-Click Cancel to cancel the sign-in process. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button. Figure 11: The Patient Information pane. XE "Definitions for source selections (national)" Definitions for Nationally Released Source SelectionsThe EDIS technical working group (TWG) has provided the following definitions for nationally released source selections: XE "Definitions for source selections (national):Non-VA Clinic/Office" Non-VA Clinic/Office—a non-VA clinic, primary care, or other type of provider sent the patient. XE "Definitions for source selections (national):VA Clinic, Off-Site" VA Clinic, Off-Site—an offsite VA clinic—a community-based outpatient clinic (CBOC), for example—sent the patient. XE "Definitions for source selections (national):On-Site Clinic" On-Site Clinic—an onsite physician, nurse practitioner, physician assistant, nurse, or other care provider sent the patient for evaluation. XE "Definitions for source selections (national):Non-VA Nursing Home" Non-VA Nursing Home—a non-VA community living center (CLC) sent the patient. XE "Definitions for source selections (national):VA Nursing Home, Off-Site" VA Nursing Home, Off-Site—an off-campus VA CLC transferred the patient. XE "Definitions for source selections (national):On-Site Nursing Home" On-Site Nursing Home—an on-campus VA CLC transferred the patient. XE "Definitions for source selections (national):Self-Referred" Walk In—the patient presents from outside the community without a referral—regardless of his or her mode of transportation. XE "Definitions for source selections (national):Transfer, Other" Transfer, Other—other facilities transferred the patient (VA ED-to-ED transfers for subspecialty care would be included in this category). XE "Add patients:Identify patients" XE "Identify patients" Identify PatientsThe Identify Patient button enables you to identify patients in VistA after you’ve added them to the application via the Enter Name – Patient Is Not in VistA or Ambulance Is Arriving, Patient Name Is Unknown selection. This button also allows you to identify patients who arrived by ambulance and are not in VistA. Identify Patient is available only for patients whom users added via one of these selections. The application displays this button on the Patient Information bar in the following views:Sign InTriageUpdateDispositionEdit ClosedIf you or another user has added the wrong patient using the Search for Patient in VistA selection, you can remove the patient from the board by selecting Patient Name Entered in Error on the Disposition list. (See Section 8, “Disposition View.”)Figure 12: The Identify Patient button.Identifying Patients In the Active Patients list, select the patient whom you want to identify. Keyboard: use the <Tab> key to locate the Active Patients list and use the <Down Arrow> key to enter the list. Use the <Down Arrow> or <Up Arrow> key to select a patient from the list. Click the Identify Patient button in the Patient Information bar. The application displays the Identify Patient dialog box. Keyboard: use the <Tab> key to locate the Identify Patient button. Use the <Spacebar> key to select the button.Type all or part of the patient’s name in the Find Patient box using this format: Surname,First name. For example, you can search using the patient’s surname only, or the patient’s surname and the first initial of his or her first name. You can also search using the initial letter of the patient’s surname concatenated with the last four digits of his or her Social Security number (X9999 format), the patient’s entire Social Security number (SSN), or the last four digits of his or her SSN. Select the patient from this list and press the <Enter> key or click Continue. Keyboard: use the <Down Arrow> and <Up Arrow> keys to locate the patient’s name. Use the <Enter> key to select the patient. You can also select the patient by using the <Tab> key to locate the Continue button and the <Spacebar> key to select the button. If your patient is not on the list and you added him or her via the Ambulance Is Arriving, Patient Name Is Unknown selection, click the Enter Name, Patient Is Not in VistA button. Keyboard: use the <Tab> key to locate the Search for Patient in VistA button and then use the <Down Arrow> key to locate the Enter Name, Patient Is Not in VistA button. Press the <Spacebar> key to select this button. EDIS automatically populates the Patient Name box with the name you typed in the Find Patient box. Correct this name if necessary. Keyboard: use the <Tab> key to locate the Patient Name box. Press the <Enter> key or click Continue. Keyboard: use the <Tab> key to locate the Continue button and use the <Spacebar> key to select it. Click Save. Keyboard: use the <Tab> key to locate the Save button and use the <Spacebar> key to select the button. XE "Triage view"Triage ViewUse the Triage view to edit or update information that you gather as part of the triage process. From this view, you can update patients’ display-board complaints; include additional, not-for-display information about their complaints (optional); update their room or area assignments; add information about their acuities; make nursing, provider, and resident assignments; update or add their sources (on-site clinics, nursing homes, and so forth); and specify a clinic location for the patient’s emergency-department visit. You can also add patients to the display board from the Triage view. Figure 13: The Triage view. XE "Add patient:Triage view" Add Patients to EDIS from the Triage ViewFigure 14: The Add Patient dialog box.Click Add Patient in the upper right-hand corner of the Active Patients list. Keyboard: use the <Tab> key to locate the Add Patient button and press the <Spacebar> key to select it. The application displays the Add Patient dialog box, which offers the following three selections: Search for Patient in VistA: enables you to add patients who are already in your local VistA systemAmbulance Is Arriving, Patient Name Is Unknown: enables you to add information for patients whose identities are unknown (EDIS does not create PCE visits for these patients until someone adds them via a VistA search)Enter Name, Patient Is Not in VistA enables you to add patients who are not in your local VistA system (EDIS does not create PCE visits for these patients until someone adds them via a VistA search)EDIS does not activate the Add Patient button when you are already in the process of signing in or triaging a patient. To activate the Add Patient button in this case, you must click Save to complete the triage process for the current patient or Cancel to cancel the process and discard the information you’ve entered. XE "Add patient:Search for Patient in VistA" Adding Patients Using the Search for Patient in VistA SelectionIf necessary, select Search for Patient in VistA. (Search for Patient in VistA is the application’s default selection; in most cases, you won’t need to manually select this button.) Keyboard: if the Search for Patient in VistA button isn’t selected, use the <Tab> key to locate the selected button (Enter Name, Patient Is Not in VistA or Ambulance Is Arriving, Patient Name Is Unknown). Use the <Up Arrow> key to locate the Search for Patient in VistA button, and use the <Spacebar> key to select it. Type all or part of the patient’s name in the Find Patient box using this format: Surname, First name. For example, you can search using the patient’s surname only, or the patient’s surname and the first initial of his or her first name. You can also search using the initial letter of the patient’s surname concatenated with the last four digits of his or her Social Security number (X9999 format), the patient’s entire Social Security number (SSN), or the last four digits of his or her SSN. Keyboard: use the <Tab> key to locate the Find Patient box. Use an underscore to denote spaces in names. For example, if the patient’s name is O Hara, type O_Hara. Click Search or press the <Enter> key. The Add Patient dialog box lists possible matches. Select the correct patient and press the <Enter> key or click Continue. Keyboard: use the <Down Arrow> or <Up Arrow> key to locate the correct patient. Press the <Enter> key to select the patient. You can also select the patient by using the <Tab> key to locate the Continue button and then pressing the <Spacebar> key to select the button.EDIS starts its timer when you click Continue. The application displays the Patient Information pane. XE "Add patient:Enter Name, Patient Is Not in VistA" Adding Patients Using the Enter Name Selection If the Find Patient search list does not contain a match, add the patient using the Enter Name, Patient Is Not in VistA selection.In the Add Patient dialog box, select Enter Name, Patient Is Not in VistA. Keyboard: use the <Tab> key to locate the Search for Patient in VistA (or currently selected) button. Use the <Down Arrow> (or <Up Arrow>) key to locate the Enter Name, Patient Is Not in VistA button. Use the <Spacebar> key to select this button. Type the patient’s full name in the Patient Name box using this format: Lastname,First name. Keyboard: use the <Tab> key to locate the Patient Name box.Click Continue or press the <Enter> key. Figure 15: The Enter Name, Patient Is Not in VistA button.The application displays the Patient Information pane. XE "Add patient:Adding unidentified patients" Adding Unidentified PatientsWhen adding unresponsive patients whose identities you do not know, use the Enter Name, Patient Is Not in VistA selection and follow the naming protocol defined in section 12 of VHA Directive 2006-036: Data Quality Requirements for Identity Management and Master Patient Index Functions. (Use the name UU-UNRESPONSIVE,PATIENT for the first such patient, UU-UNRESPONSIVE,PATIENT A for the second, UU-UNRESPONSIVE,PATIENT B for the third, and so forth. You can find the full text of this directive at REDACTED XE "Add patient:Ambulance Is Arriving, Patient Name Is Unknown" Adding Patients Using the Ambulance Is Arriving SelectionEDIS enables you to prepare for unknown patients who are arriving by ambulance or other types of emergency transportation. You can make room, provider, and nurse assignments before these patients arrive. Select Ambulance Is Arriving, Patient Name Is Unknown. Keyboard: use the <Tab> key to locate the currently selected button (Search for Patient in VistA or Enter Name, Patient Is Not in VistA). Use the <Down Arrow> key to locate the Ambulance Is Arriving, Patient Name Is Unknown button. Click Continue. Keyboard: use the <Tab> key to locate the Continue button and use the <Spacebar> key to select it. Figure 16: The Add Patient dialog box with the Ambulance Is Arriving, Patient Name Is Unknown button selected.The application displays the Patient Information pane. XE "Triage view:Add triage information" XE "Add triage information" Add Triage InformationIn the Active Patients list, select the patient whose triage information you want to enter. Keyboard: use the <Tab> key to locate the Active Patients list. Use the <Down Arrow> key to enter the list, and use the <Down Arrow> and <Up Arrow> keys to locate the patient you want to select. The Patient Information pane displays current information for the selected patient.If applicable, update the patient’s display-board complaint in the XE "Complaint for display board entries" Complaint for Display Board box. If you added the patient from the Triage view, you must type a display-board complaint. The application will not allow you to add the patient if the Complaint for Display Board box is empty. Keyboard: use the <Tab> key to locate the Complaint for Display Board box. In the XE "Long complaint entries" Long Complaint (optional) box, you may type supplementary information about the patient’s display-board complaint. Keyboard: use the <Tab> key to locate the Long Complaint (optional) box.If applicable, open the XE "Room and area entries" Room / Area list and make or update the patient’s room or area assignment. (Room or area information is mandatory; the waiting room is the application’s default selection.) Keyboard: use the <Tab> key to locate the Room / Area list, and use the <Down Arrow> and <Up Arrow> keys to select a room or area from the list. XE "Acuity entries" Select an acuity value from the Acuity list. Acuity information is mandatory for this view. If you do not select an acuity, the application will not allow you to save your updates or edits. Keyboard: use the <Tab> key to locate the Acuity list. Use the <Down Arrow> and <Up Arrow> keys to select an acuity. XE "Emergency Severity Index:ESI" EDIS supports the Emergency Severity Index (ESI) triage algorithm, which ranks patients’ acuities using the numbers 1 (most urgent) through 5 (least urgent). Please visit the Agency for Healthcare Research and Quality ESI Web site for more information.Open the XE "Status entries" Status list and select the patient’s status. Keyboard: use the <Tab> key to locate the Status list. Use the <Down Arrow> and <Up Arrow> keys to select a status from the list. (You can find a list of status definitions in section 6.2.1 of this guide.) XE "Provider entries" Select a provider from the Provider list. Keyboard: use the <Tab> key to locate the Provider list and use the <Down Arrow> and <Up Arrow> keys to select the patient’s provider assignment from the list. The Provider list is also available on the Update and Disposition views. XE "Resident entries" If the Resident list (controlled by a site-selectable parameter) is available, select a resident from the list. Keyboard: use the <Tab> key to locate the Resident list and use the <Down Arrow> and <Up Arrow> keys to select a resident from the list. If the Resident list is available on the Triage view, it is also available on the Update and Disposition views. XE "Nurse entries" Select a nurse from the Nurse list. Keyboard: use the <Tab> key to locate the Nurse list. Use the <Down Arrow> and <Up Arrow> keys to select a nurse from the list. The Nurse list is also available on the Update view. When you make a provider assignment in EDIS, the application automatically creates a Patient Care Encounter (PCE) visit in CPRS—if it hasn’t already done so, or unless the provider does not have an active person class in VistA. EDIS does not create visits for patients you’ve added using the Enter Name, Patient Is Not in VistA and Ambulance Is Arriving, Patient Name Is Unknown selections. It does not create visits when you enter only resident or nurse assignments. However, EDIS does create visits in CPRS for nurse assignments if the nurses in question are listed in VistA’s Provider file.EDIS does not register patients. If applicable, add or edit the patient’s source from the XE "Source entries" Source list. (Definitions for nationally released sources are available in section 4.1.5 of this guide.) Keyboard: use the <Tab> key to locate the Source list and use the <Down Arrow> and <Up Arrow> keys to select a source from the list.If the XE "Clinic entries" Clinic list is available, select the location that you want EDIS to use for creating the patient’s PCE visit. This list is controlled by site-selected parameters. If your site’s emergency department has only one location, or uses only one location at any given time, this list may not be available. The list is also unavailable if a PCE visit is already associated with the patient’s emergency-department episode of care. Click Save to save your edits and updates or click Cancel to close the Patient Information pane without saving your changes. The Save button is available only after you’ve added or updated information in the Patient Information pane. Keyboard: use the <Tab> key to locate either the Save or Cancel button. Press the <Spacebar> key to select the button. XE "Definitions for status selections (national)" Definitions for Status SelectionsThe EDIS TWG has provided the following definitions for nationally released status selections: XE "Definitions for status selections (national):Admitted" Admitted—the patient is admitted, but is still in the emergency department. XE "Definitions for status selections (national):ED Boarding [Hold}" ED Boarding [Hold]—the patient is admitted and is designated as a holder (extended time in the emergency department). XE "Definitions for status selections (national):Discharged" Discharged—the patient is discharged, but is still in the emergency department. XE "Definitions for status selections (national):ED Observation Unit" ED Observation Unit—the patient is an observation patient under the emergency department’s care. XE "Definitions for status selections (national):ED Patient" ED Patient—the patient is an emergency department patient (after triage). XE "Definitions for status selections (national):En Route/Prearrival" En Route/Prearrival—the patient is en route to the emergency department. XE "Definitions for status selections (national):Awaiting Triage" Awaiting Triage—the patient is at the emergency department and is awaiting triage.Other Status-list selections are site configurable. XE "Triage view:Creating visits in CPRS" XE "Creating visits in CPRS" Create a Visit in CPRSAdding a provider (or a nurse who has an active person class in the New Person file) in EDIS automatically creates a PCE visit in CPRS—unless EDIS has already created a visit for this particular emergency-department episode of care (through Appointment Management, for example) or the provider does not have an active person class in VistA’s New Person file. To reduce the possibility of creating duplicate PCE visits in CPRS, EDIS checks back one hour for PCE visit entries associated with the emergency department location your site’s IT staff has specified. (EDPF LOCATION parameter settings and—if applicable—Clinic list selections determine the location EDIS uses to create visits.)The application creates only one PCE visit in CPRS for each emergency-department episode of care (or encounter).You can avoid creating duplicate visits for the same episode of care by selecting the visit that EDIS creates when you complete patients’ emergency-department encounters in CPRS. REDACTEDFigure 17: Adding provider assignments in EDIS creates PCE visits in CPRS. XE "Update view" Update ViewThe Update view enables you to add or update the following information:Room or area assignmentsPatients’ statusesProvider assignmentsResident assignments Nurse assignmentsComments Figure 18: The Update view. XE "Update view:Add update information" Add or Update Information in the Patient Information PaneClick Update in the application’s left-hand menu bar. Keyboard: use the <Tab> key to locate the left-hand menu bar and use the <Up Arrow> or <Down Arrow> key to locate the Update view. Press the <Spacebar> key to select this view.Select from the Active Patients list the patient whose information you want to edit or update. Keyboard: use the <Tab> key to locate the Active Patients list. Use the <Down Arrow> and <Up Arrow> keys to select from the list the patient whose data you want to update.In the Patient Information pane, select and edit the fields and staff assignments you want to update. Keyboard: use the <Tab> key to locate information fields. Use the <Down Arrow> and <Up Arrow> keys to select items from lists.When you make a provider assignment in EDIS, the application automatically creates a PCE visit in CPRS—if it hasn’t already done so, or unless the provider does not have an active person class in VistA. EDIS does not create visits for patients you’ve added using the Enter Name, Patient Is Not in VistA or Ambulance Is Arriving, Patient Name Is Unknown selections.As a rule, EDIS requires you to enter a provider before allowing you to remove a patient from the board. Exceptions to this rule apply to the following dispositions: Patient Name Entered in Error, Left Without Being Treated/Seen, and Sent to Nurse Eval / Drop In Clinic.Click Save to save your edits and updates or click Cancel to close the Patient Information pane without saving your changes. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button. The Save button is available only after you’ve added or updated information in the Patient Information pane. XE "Update view:Creating a visit in CPRS" XE "Creating a visit in CPRS" Create a Visit Adding a provider in EDIS automatically creates a PCE visit in CPRS—unless EDIS has already created a PCE visit for this particular emergency-department episode of care, the patient hasn’t yet been identified in VistA, or the provider you assigned does not have a valid person class in VistA. To reduce the possibility of creating duplicate visits, EDIS checks back one hour for PCE visit entries associated with the emergency department location you or your site’s IT staff have specified. (EDPF LOCATION parameter settings and—if applicable—Clinic list selections determine the location EDIS uses to create visits. The Clinic list is available on the Triage view.)The application creates only one PCE visit in CPRS for each emergency-department episode of care (or encounter).You can avoid creating duplicate visits for the same episode of care by selecting the visit that EDIS creates when you complete patients’ emergency-department encounters in CPRS. EDIS displays a green checkmark in the Display Board view’s Visit column to indicate that it has created a visit in CPRS. XE "Update view:Setting patients' primary providers" XE "Setting patients' primary providers" Setting a Primary Provider for Your Patient’s VisitWhen you select a physician from EDIS’s Provider list, the application sets the physician as the primary provider for your patient’s visit in CPRS. If you subsequently change the assigned physician in EDIS, EDIS assigns the new physician as the primary provider for the visit in CPRS. In this case, EDIS assigns the originally selected physician as a secondary provider. When you select a primary provider for the patient’s emergency-department visit in CPRS, EDIS updates its Provider selection to reflect this change. XE "Disposition view" Disposition View The Disposition view enables you to enter patients’ dispositions and either free-text or ICD-9-CM diagnoses, depending upon how your site sets the application’s parameters. If your site has enabled coded diagnoses, entering a diagnosis in EDIS adds the diagnosis to the emergency-department visit EDIS creates in CPRS. Conversely, adding a diagnosis for the current emergency-department visit in CPRS automatically adds the diagnosis in EDIS. (EDIS creates the visit when you select a provider in the Update or Triage view, or when you add a diagnosis in the Disposition view.) For example, a possible workflow for providers might include adding patients’ discharge diagnoses in CPRS when the providers are signing notes and completing EDIS-created encounters. In this workflow, EDIS would automatically update these patients’ diagnoses in its Disposition view. Also depending on your site’s configuration, the Disposition view may require you to select a disposition or a delay reason (for patients whose emergency-department stays have exceeded your site’s specified time limit), or both. In addition, this view enables you to add or update provider and resident assignments, update room and area assignments, update patients’ statuses, and remove patients from the display board.Figure 19: Disposition view with ICD-9-CM diagnoses enabled. XE "Disposition view:Selecting a disposition" XE "Selecting a disposition" Select a DispositionClick Disposition on the left-hand menu pane. Keyboard: from the left-hand menu pane, use the <Up Arrow> or <Down Arrow> key to locate Disposition. Press the <Spacebar> key to select Disposition.Select a patient in the Active Patients list. The application displays the Patient Information pane. Keyboard: use the <Tab> key to locate the Active Patients list. Use the <Down Arrow > and <Up Arrow> keys to select a patient from the list. Open the Disposition list and select a disposition. Depending upon your site’s configuration, the application may require a disposition before allowing you to remove a patient from the display board. Keyboard: use the <Tab> key to locate the Disposition list. Use the <Down Arrow> and <Up Arrow> keys to select a disposition from the list.Click Save to save your changes or click Cancel to close the Patient Information pane without saving your changes. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button.The Save button is available only after you’ve added or updated information in the Disposition pane. XE "Disposition definitions (national)" Definitions for National DispositionsThe EDIS TWG offers the following definitions for nationally released dispositions: XE "Disposition definitions (national):Admitted to VA Ward" Admitted to VA Ward—the patient was admitted to an inpatient location, not including an ICU, telemetry, or psychiatric unit. XE "Disposition definitions (national):AMA" AMA—the patient left against medical advice after signing a form; the patient may or may not have been medically evaluated before leaving. XE "Disposition definitions (national):Sent to Urgent Care Clinic" Sent to Urgent Care Clinic—the patient was discharged from the emergency department and referred to another evaluation clinic at the same site; some degree of triage is necessary to make this judgment. XE "Disposition definitions (national):Deceased" Deceased—the patient is dead. XE "Disposition definitions (national):Eloped" Eloped—the patient left the emergency department and his or her disposition is unknown; a nurse or physician may have seen and evaluated the patient. XE "Disposition definitions (national):Patient Name Entered in Error" Patient Name Entered in Error—the patient’s name was entered in error; this disposition removes the patient from the board. XE "Disposition definitions (national):Home" Home—the patient was discharged to his or her previous living arrangement. XE "Disposition definitions (national):Admitted to ICU" Admitted to ICU—the patient was admitted to an inpatient critical care unit. XE "Disposition definitions (national):Left Without Being Treated/Seen" Left Without Being Treated/Seen—the patient left the emergency department before receiving treatment and before signing the form; this is not the same as AMA, which assumes the patient signed a form before leaving. XE "Disposition definitions (national):Sent to Nurse Eval / Drop-in Clinic" Sent to Nurse Eval / Drop-in Clinic—the patient was discharged from the emergency department and referred to another on-campus same-day evaluation clinic; some degree of triage is necessary to make this judgment. XE "Disposition definitions (national):Admitted to Psychiatry" Admitted to Psychiatry—the patient was admitted to an inpatient psychiatric unit. XE "Disposition definitions (national):Admitted to Telemetry" Admitted to Telemetry—the patient was admitted to an inpatient telemetry unit. XE "Disposition definitions (national):Transferred to a Non-VA Facility" Transferred to a Non-VA Facility—the patient was discharged from the emergency department and sent to another, non-VA, facility. XE "Disposition definitions (national):Transferred to VA Facility" Transferred to VA Facility—the patient was discharged from the emergency department and sent to another VA facility.Sites can activate and inactivate these dispositions. The application allows your site to configure additional, site-specific dispositions. To capture admission-delay times for reporting, you must change patients’ statuses to Admitted and then immediately select Admitted to VA Ward as their dispositions. Unless you intend to remove patients from the board, click Save. Do not click Save & Remove from Board, which will prematurely remove your patients from the EDIS tracking application. XE "Disposition view:Selecting a reason for delay" XE "Selecting a reason for delay" Select a Reason for DelayIf the Delay Reason list is available, open it and select a reason for delay. Depending upon your site’s configuration, the application may require a reason for delay when patients’ emergency-department visits have exceeded a specified number of minutes. Keyboard: use the <Tab> key to locate the Delay Reason list. Use the <Down Arrow> and <Up Arrow> keys to select a delay reason from the list. The Delay Reason list is available only under the following conditions:Your site requires a delay reason and The patient’s stay has exceeded the site-determined limit andThe patient is not in an observation ward Click Save to save your changes or Cancel to close the Patient Information pane without saving your changes. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button.If your site requires a reason for delay and the patient’s stay has exceeded the maximum number of minutes your site has specified, the application will require you to enter a delay reason before it allows you to remove the patient from the display board. XE "Delay reason definitions" Definitions for National Reason-for-Delay SelectionsThe EDIS TWG offers the following definitions for nationally released reason-for-delay selections. Your site is not required to include all selections in its pick list. EDIS test sites recommend limiting pick lists to reasons that are relevant at your site because over-long lists affect compliance. XE "Delay reason definitions:Obtain Accepting Physician" Obtain Accepting Physician—the delay was caused by the inability to find an accepting physician to admit the patient. This selection includes the elapsed time between determining the patient’s need for admission and obtaining an accepting physician. XE "Delay reason definitions:Admit Physician Writing Dispo" Admit Physician Writing Dispo—the delay resulted from the physician’s failure to write the patient’s admit or discharge order. This selection includes the elapsed time between when the patient was ready for his or her disposition and when the physician wrote the order to admit or discharge the patient. XE "Delay reason definitions:Admitting Physician Evaluation" Admitting Physician Evaluation—the delay was related to the admitting physician’s evaluation and confirmation of the patient’s disposition. For this selection, delay time begins when the physician sees the patient and ends when:H&P is doneAncillary studies that are necessary for disposing the patient are done and resultedThe patient is ready to be disposed XE "Delay reason definitions:Patient Admitted to Observation" Patient Admitted to Observation—the delay resulted from the patient’s admission to observation. This selection includes the elapsed time between when the patient was ready to be disposed and the time the physician wrote an order to admit the patient to 23 hours of emergency department or floor observation. XE "Delay reason definitions:Obtain Ambulance Services" Obtain Ambulance Services—the delay resulted from the time it took to obtain ambulance services. This selection includes the elapsed time between when emergency department staff requested ambulance services and the time the ambulance arrived. XE "Delay reason definitions:Obtain Consultant" Obtain Consultant—the delay resulted from an ordered consultation’s lack of completion. This selection includes the elapsed time from when a physician ordered a consultation to the time the physician obtained the consultation. XE "Delay reason definitions:ED to Hospital Bed" ED to Hospital Bed—the delay represents the difference between the time the patient was assigned a hospital bed and the time the patient was transported from the emergency department; for example, this delay could represent the time emergency department staff spent waiting for an escort, for a bed to be cleaned, for a nursing report, or for staffing. XE "Delay reason definitions:Obtain Escort" Obtain Escort—the delay resulted from the time it took to obtain an escort for the purpose of transporting the patient (not including transport to a hospital bed—use ED to Hospital Bed for this reason). This selection includes the time that elapsed between when the emergency department called an escort and the time the escort arrived to transport the patient to a clinic, radiology, or another ancillary department. XE "Delay reason definitions:Patient Transport Home" Patient Transport Home—the delay resulted from an inability to find transportation for a discharged patient or the time it took the identified source of transportation to arrive at the emergency department. This selection includes the elapsed time between when the patient was ready for discharge and the time the patient left the emergency department. XE "Delay reason definitions:Obtain Imaging Results" Obtain Imaging Results—the delay resulted from time spent waiting to obtain imaging results. This selection includes the elapsed time between when the imaging study was completed and the time the study was resulted. XE "Delay reason definitions:Obtain Imaging Studies" Obtain Imaging Studies—the delay resulted from time spent waiting for imaging studies. This selection includes the elapsed time between when the physician ordered the imaging study and the time the study was done and ready for interpretation. XE "Delay reason definitions:Obtain Inpatient Bed" Obtain Inpatient Bed—the delay resulted from the time spent waiting for an impatient bed assignment. This selection includes the elapsed time between when the physician wrote the admission order and the time bed control or the house supervisor assigned the patient to a bed—the time an ICU patient waited for an ICU bed to open up, for example. XE "Delay reason definitions:Interfacility Transfer" Interfacility Transfer—the delay was caused by an inability to transfer the patient to another facility in a timely manner. XE "Delay reason definitions:Obtain Lab Results" Obtain Lab Results—the delay was caused by the lack of a timely turnaround for laboratory tests. This selection includes the elapsed time between when labs were drawn or obtained and the time the labs were resulted. XE "Delay reason definitions:Obtain Lab Studies" Obtain Lab Studies—the delay was caused by an inability to get labs drawn in a timely fashion. This selection includes the elapsed time between when the physician wrote the lab order and the time the lab test was drawn. XE "Delay reason definitions:On-call Staff" On-call Staff—the delay was caused by an inability to contact on-call staff. XE "Delay reason definitions:Overcrowding of ED" Overcrowding of ED—the delay resulted from waiting for an emergency department bed to become available (includes hallway beds and beds that were unavailable because of staffing issues); no beds were available for inbound ambulances, including hallway beds. XE "Delay reason definitions:Obtain Drugs/Pharmacology" Obtain Drugs/Pharmacology—the delay was caused by an inability to get ordered drugs from the pharmacy. This selection includes the elapsed time between when the physician ordered the medications and the time the emergency department received the medications. XE "Delay reason definitions:ED Physician Limits" ED Physician Limits—the delay resulted from time the physician spent seeing patients. This selection includes the elapsed time between when the patient was placed in a bed and when the physician saw the patient. For example, this reason for delay might apply if five patients presented with chest pains, all within 10 minutes. XE "Delay reason definitions:ED Staff Limits" ED Staff Limits—the delay resulted from a failure to process the patient (see the patient or accomplish orders, for example) in a timely manner because of insufficient staffing. This selection includes the elapsed time between when the physician wrote an order (to splint a broken ankle, for example) and the time the order was accomplished. XE "Delay reason definitions:Obtain Medical Supplies" Obtain Medical Supplies—the delay resulted from an inability to obtain medical supplies (splints, crutches, and c-line kits, for example) in a timely manner. This selection includes elapsed time from when emergency department personnel ordered the supplies (or identified the need for them) and the time the emergency department received the supplies. XE "Delay reason definitions:Arrange Emergency Surgery" Arrange Emergency Surgery—the delay resulted from the time it took to get the patient (who needed surgery) to the operating room. XE "Delay reason definitions:Patient Transport Other" Patient Transport Other—the delay resulted from the time it took to find transportation for the patient to a location other than home. This selection includes the elapsed time between when the patient was ready for transport and the time the patient left the emergency department. XE "Entering ICD-9-CM diagnoses" XE "Disposition view:Entering ICD-9-CM diagnoses" Enter ICD-9-CM DiagnosesType a diagnosis in the Diagnosis search box and click Search or press the <Enter> key. The application lists possible matches from VistA’s ICD-9-CM code base. Keyboard: use the <Tab> key to locate the Diagnosis search box. Type a diagnosis in the box and press the <Enter> key. Select an ICD-9-CM diagnosis from the Diagnosis search list and click Add or press the <Enter> key. The application adds this diagnosis to the Selected Diagnoses list. Keyboard: use the <Down Arrow> and <Up Arrow> keys to locate the diagnosis you want to select. Press the <Enter> key to select the diagnosis. To select another diagnosis from the same search list, use the <Tab> key to reenter the list. Use the <Down Arrow> and <Up Arrow> keys to locate the additional diagnosis, and press the <Enter> key to select this diagnosis. You can also select diagnoses by using the <Tab> key to locate the Add button, then pressing the <Spacebar> key to select the button. To remove a diagnosis from the Selected Diagnoses list, select the diagnosis and click Remove or press the <Delete> key. Keyboard: use the <Tab> key to locate the Selected Diagnoses list. Use the <Down Arrow> and <Up Arrow> keys to locate the diagnosis you want to remove. Press the <Delete> key to remove the diagnosis. You can also simultaneously press the <Shift> and <Tab> keys to locate the Remove button, and then press the <Spacebar> key to remove the selected diagnosis. Repeat steps 1–3 as needed.In the Selected Diagnoses list, select a primary diagnosis and click Set as Primary Diagnosis. Keyboard: in the Selected Diagnoses list, use the <Down Arrow> and <Up Arrow> keys to locate the primary diagnosis. Use the <Tab> key to locate the Set as Primary Diagnosis button, and use the <Spacebar> key to select this button. Click Save to save your changes or Cancel to close the Patient Information pane without saving your changes. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button. Saving an ICD-9-CM diagnosis in EDIS adds the diagnosis to the patient’s emergency-department visit in CPRS. If EDIS hasn’t already created a PCE visit for this patient, it will also create a visit at this time. The application does not add free-text diagnoses to the patient’s visit in CPRS. XE "Entering free-text diagnoses" XE "Disposition view:Entering free-text diagnoses" Enter Free-Text Diagnoses You can type in free-text diagnoses only if your site has set the parameter that enables you to do so.Type a diagnosis or procedure in the Diagnosis box and click Add or press the <Enter> key. Keyboard: use the <Tab> key to locate the Diagnosis box. Type a diagnosis in the box and press the <Enter> key. You can also press the <Tab> key to locate the Add button and press the <Spacebar> key to select the button. The application displays your diagnosis or procedure in the Selected Diagnoses list. To remove an item from the Selected Diagnoses list, select the item and click Remove or press the <Delete> key. Keyboard: use the <Tab> key to locate the Selected Diagnoses list and use the <Down Arrow> and <Up Arrow> keys to locate and select the diagnosis you want to remove. Use the <Delete> key to remove the diagnosis. You can also remove the diagnosis by simultaneously pressing the <Shift> and <Tab> keys to locate the Remove button, then pressing the <Spacebar> key to select the button. Repeat steps 1–2 as needed.In the Selected Diagnoses list, choose a primary diagnosis, then click Set as Primary Diagnosis. Keyboard: use the <Tab> key to enter the Selected Diagnoses list and the <Down Arrow> and <Up Arrow> keys to locate the primary diagnosis. Use the <Tab> key to locate the Set as Primary Diagnosis button and use the <Spacebar> key to select it. Click Save to save your changes or click Cancel to close the Patient Information pane without saving your changes. Keyboard: use the <Tab> key to locate the Save or Cancel button. Use the <Spacebar> key to select the button.Figure 20: The Disposition view with free-text diagnoses enabled. XE "Removing patients from the board" XE "Disposition view:Removing patients from the board" Remove Patients Click the Save & Remove from Board button to save changes and remove patients from the display board. Keyboard: use the <Tab> key to locate the Save & Remove from Board button. Use the <Spacebar> key to select the button.This button is available only after users have entered all of the disposition information your site’s EDIS implementation requires. If you haven’t entered a provider or acuity, the application alerts you to do these things before it allows you to save your changes and remove your patient from the board—unless your patient’s disposition is Patient Name Entered in Error, Left Without Being Treated / Seen, or Sent to Nurse Eval / Drop In Clinic. Clicking the Save & Remove from Board button removes patients from the display board and saves previously unsaved changes. While the application retains information about the visits of patients you’ve removed from the display board, only users who have access to the Edit Closed view will have direct access to this information. Users who have access to the Reports view will have indirect access to this information. XE "Removing patients who were entered in error" XE "Disposition view:Removing patients who were entered in error" Remove Patients Entered in ErrorOpen the Disposition list. Keyboard: use the <Tab> key to locate the Disposition list.Select Patient Name Entered in Error. Keyboard: use the <Down Arrow> key to select Patient Name Entered in Error.Click Save & Remove from Board. Keyboard: use the <Tab> key to locate the Save & Remove from Board button and press the <Spacebar> key to select it. XE "Edit Closed view" Edit Closed ViewThis view enables authorized users to edit the EDIS records of patients who are no longer on the display board. EDIS logs all changes for subsequent reference (as it does with changes users make while patients are still signed in to the emergency department). If your site uses PCE instead of Appointment Management, the Edit Closed view provides a lookup tool; you can use this view to search for specific patients who visited your emergency department on a specific date. Figure 21: The Edit Closed view.Click Edit Closed on EDIS’s left-hand navigation menu. Keyboard: use the <Tab> key to locate the left-hand menu. Use the <Down Arrow> or <Up Arrow> key to locate Edit Closed. Press the <Spacebar> key to select Edit Closed.Type a date (mm/dd/yy format) or all or part of the patient’s name (Surname, First name format) in the Patient Name or Date box. For example, you can type the patient’s surname initial, entire surname, or surname and first-name initial. You can also type the patient’s full SSN, the initial letter of the patient’s surname concatenated with the last four digits of his or her SSN (X9999 format), the word today (for a list of today’s visits), or t-n ( where t represents today, and n represents the number of days prior to today). Keyboard: use the <Tab> key to locate the Patient Name or Date box.Click Search or press the <Enter> key. EDIS lists possible matches in the search-results list. Select from this list the patient whose record you want to update. EDIS displays the Patient Information pane, which contains information about the selected patient’s emergency department visit. Keyboard: use the <Tab> key to locate the search-results list. Use the <Down Arrow> key to enter the list and the <Down Arrow> and <Up Arrow> keys to select the patient whose record you want to update. To identify a previously unidentified patient, click Identify Patient in the Patient Information bar. EDIS displays the Add Patient dialog box. Keyboard: use the <Tab> key to locate the Identify Patient button and use the <Spacebar> key to select it. The Add Patient dialog offers two ways to identify patients: Search for Patient in VistA and Enter Name, Patient Is Not in VistA. Search for Patient in VistA is the application’s default selection. To search for the patient in VistA, type all or part of the patient’s name in the Find Patient box (Surname,Firstname format) and either click Search or press the <Enter> key. You may also type the patient’s full SSN, the last four digits of the patient’s SSN, or the initial letter of the patient’s surname concatenated with the last four digits of his or her SSN (X9999 format). EDIS displays a list of possible matches. Select the patient’s name and click Continue. Keyboard: use the <Down Arrow> and <Up Arrow> keys to locate the patient’s name. Press the <Enter> key to select the name. If the patient is not included in the list, select Enter Name, Patient Is Not in VistA. EDIS displays the Patient Name box. Keyboard: use the <Tab> key to locate the Search for Patient in VistA button, then use the <Down Arrow> key to locate the Enter Name, Patient Is Not in VistA button. Press the <Spacebar> key to select this button. Type the patient’s name in the Patient Name box and click Continue. Keyboard: use the <Tab> key to locate the Continue button and use the <Spacebar> key to select this button.Add or update other data-entry fields as necessary. You can add information to, or update, the following fields: Complaint for Display Board, Long Complaint (optional), Room / Area, Acuity, Status, Provider, Resident, Nurse, Comments, Source, Disposition, Delay Reason, Selected Diagnoses, Time In, and Time Out. (Click the Time In or Time Out spin-box arrows or use the <Up Arrow> and <Down Arrow> keys to edit the patient’s time in or time out.)Click Save to save your changes or click Cancel to discard them. Keyboard: use the <Tab> key to locate the Save or Cancel button and use the <Spacebar> key to select the button of your choice. If you attempt to change the time out value (or other value) for a patient who left the emergency department before he or she was seen, EDIS will not allow you to save your change until you add a provider name.The Save button is available only after you’ve added or updated information in the Patient Information pane. The application allows you to save your changes only if all required data fields contain valid entries. XE "PC-based Display Board view" Display Board ViewYour site can configure one or more display boards, depending on its needs. The Display Board view offers a PC- or workstation-based preview of your site’s main electronic whiteboard display configuration. If you have access to this view, you can customize it as you would any other grid-based view: Arrange columnsResize columnsSort within columnsSee the “Work with Data Grids” section of this document for information about how to arrange, resize, and sort within columns. Sorting information within columns in the PC-based Display Board view does not cause EDIS to similarly sort information in large electronic (LCD) whiteboard display columns. EDIS sorts large display columns first in the order of the rooms and areas listed in the Room / Area configuration subview and then in the order of patients’ acuities. You cannot save layout changes you make from within this view. Further, the changes you make appear only on your local machine (as opposed to the large display). To request permanent changes in the display-board view, please contact the person who configures EDIS for your site (usually an IRM or CAC staff member). Figure 22: The Display Board view. XE "PC-based Display Board view:Viewing the PC-based display board" Viewing the Display BoardThe PC-based Display Board view contains only the columns your site has selected for its main display board. Following is a list of the columns from which your site can choose: Room / Bed: patients’ locations Clinic: the emergency department’s clinic locationsPatient Name: patients’ display namesPatient X9999: an alternative way to display patients’ names (the first letter of patients’ surnames concatenated with the last four digits of their Social Security numbers)Visit Created: a check box that indicates whether or not EDIS has created a PCE visit in CPRSComment: optional comments Complaint: patients’ display-board complaintsProvider Initials: providers’ initialsResident Initials: residents’ initialsNurse Initials: nurses’ initialsAcuity: patients’ acuities Status: patients’ statuses Lab Active/Complete: the total number of patients’ active laboratory orders relative to the total number of their completed laboratory orders Imaging Active/Complete: the total number of patients’ active imaging orders relative to the total number of their completed imaging ordersNew (Unverified) Orders: patients’ unverified orders (values decrement when nurses verify the orders in CPRS and when ancillary services [lab and imaging] complete the orders)Total Minutes: the total number of minutes that patients have been in the emergency departmentMinutes at Location: the total number of minutes that patients have been in their present locationsEDIS displays information only for laboratory, imaging, and new orders that are associated with patients’ current emergency-department visits. XE "Assign Staff view" Assign Staff ViewThis view allows authorized users to add staff names to—and remove them from—pick lists that are available in the Triage, Update, Disposition, and Edit Closed views. You can also configure text and background colors for staff assignments. Figure 23: The Assign Staff view. XE "Adding providers, residents, and nurses to staff pick lists" XE "Assign Staff view:Adding providers, residents, and nurses to staff pick lists" Add Providers, Residents, and NursesType the name of a physician, resident, or nurse in the view’s Providers, Residents, or Nurses search box, respectively. EDIS displays a list of possible matches from your local VistA system. (Nurse search lists are based on your site’s EDPF NURSE STAFF SCREEN parameter setting.) Keyboard: use the <Tab> key to locate the Providers, Residents, or Nurses search box. Select the name of the physician, resident, or nurse you want to add and click Add or press the <Enter> key. EDIS adds the name to the Provider, Resident, or Nurse list, respectively. Keyboard: use the <Down Arrow> key to enter the search list. Use the <Down Arrow> and <Up Arrow> keys to locate the name of the physician, resident, or nurse you want to add. Press the <Enter> key to add this name. Click Save Staff Changes to save your additions. Keyboard: use the <Tab> key to locate Save Staff Changes and use the <Spacebar> key to select it. XE "Assign Staff view:Removing providers, residents, and nurses from staff pick lists" XE "Removing providers, residents, and nurses from staff pick lists" Remove Providers, Residents, and NursesIn the Provider, Resident, or Nurse list, select the physician, resident, or nurse whose name you want to remove. Keyboard: use the <Tab> key to locate the Provider, Resident, or Nurse list. Use the <Down Arrow> and <Up Arrow> keys to locate the name of the provider, resident, or nurse you want to remove.Click Remove or press the <Delete> key. Click Save Staff Changes to save your changes. Keyboard: use the <Tab> key to locate the Save Staff Changes button and use the <Spacebar> key to select the button. XE "Assign Staff view:Configuring colors for providers, residents, and nurses" XE "Configuring colors for providers, residents, and nurses" Configure Colors for Providers, Residents, and Nurses The application allows you to configure text and background colors for providers, residents, and nurses.Select a physician, resident, or nurse in the Provider, Resident, or Nurse list. EDIS displays the Use Color check box. Keyboard: use the <Tab> key to locate the Provider, Resident, or Nurse list. Use the <Down Arrow> and <Up Arrow> keys to select a name from the list. Select the Use Color check box. Keyboard: use the <Tab> key to locate the Use Color check box and use the <Spacebar> key to select it. To configure a color for text, click the color-selection box labeled Text. EDIS displays a color-selection grid ( ). Click a color in the grid to select a text color. Keyboard actions are not available for this step.To configure a background color, click the color-selection box labeled Back. EDIS displays a color-selection grid. Click a color in the grid to select a background color. Keyboard actions are not available for this step.Click Save Staff Changes to save your color selections. Keyboard: use the <Tab> key to locate the Save Staff Changes button and use the <Spacebar> key to select it. Colors you configure for staff assignments will not appear on the display board unless colors (in general) are enabled for staff assignments in the Configuration view’s Display Board subview. XE "Reports view" Reports ViewEDIS can control access to the Reports view in several ways. For example, the application can deny access (in which case you don’t see the Reports selection on the application’s left-hand menu). It can also enable you to run and view eleven standard reports, and allow you to print reports and export them for use in spreadsheet applications such as Microsoft Excel. (Sites control user access to EDIS’s export feature via the EDPR EXPORT security key. Sites also use security keys to control access to two restricted reports.) Eleven Standard Reports XE "Reports view:Column headings for reports" Column HeadingsEDIS’s eleven standard reports are data grids that include one or more of the following columns:IEN: the EDIS internal entry number Time In: the time at which an EDIS user identified and added the patient, or the time at which an Appointment Management user created an emergency-department appointment for the patientTime Out: the time at which an EDIS user closed the patient’s emergency department visitComplaint: the patient’s display-board complaintMD: the initials of the patient’s physicianAcuity: the patient’s acuity levelElapsed: total elapsed time (from the patient’s time in to his or her time out, in minutes; asterisks indicate stays that have exceeded the current nationally recognized stay limit of 360 minutes) Triage: the elapsed time between the patient’s time in and his or her initial acuity assessmentWait: the elapsed time between the patient’s time in and his or her first assignment to a location other than the waiting room Disposition (Dispo): the patient’s disposition Admission Decision (Adm Dec): the elapsed time between the patient’s time in and the request for an inpatient bed (this value requires a disposition of Admitted to VA Ward or Admitted to ICU) Admission Delay (Adm Delay): the elapsed time between the patient’s Time Out (the time the patient was removed from the board) and the time of the patient’s first admitting-disposition assignmentDiagnosis: the patient’s diagnosisICD9: the patient’s ICD-9-CM diagnosis XE "Reports view:Disposition abbreviations for reports" Disposition AbbreviationsThe EDIS TWG provided the following abbreviations for nationally released dispositions; EDIS reports use these abbreviations when space is limited:VAAdmitted to VA WardAMAAMACLSent to ClinicDDeceasedEElopedERRPatient Name Entered in ErrorHHomeICUAdmitted to ICULLeft Without Being Treated/SeenNECSent to Evaluation / Same-Day ClinicPSYAdmitted to PsychiatryTAdmitted to TelemetryNVATransferred to Non-VA FacilityOTransferred to VA FacilityStandard ReportsFigure 24: The Reports view list of eleven standard reports. XE "Reports view:Activity report (standard)" XE "Activity report" Activity Report: for each patient whose visit falls within the date and-time range you select, this report lists available information in the following columns: IENTime InTime Out ComplaintMDAcuity Elapsed Triage Wait Disposition (Dispo) Admission Decision (Adm Dec) Admission Delay (Adm Delay) Diagnosis ICD9In addition, this report provides averages for several important time-based measurements (Admission Decision, Admission Delay, Elapsed, Wait, and Triage) in several patient categories:All patientsAll patients who were admittedAll patients who were not admittedAll patients in each of the following disposition categories: Deceased (D), Eloped (E), Patient Name Entered in Error (ERR), Home (H), Admitted to ICU (ICU), Left Without Being Treated/Seen (L), Sent to Nurse Eval / Drop In Clinic (NEC), Transferred to non-VA Facility (NVA), Admitted to Psychiatry (PSY), Admitted to Telemetry (T), and Admitted to VA Ward (VA). Figure 25: The Activity report. Print functionality is enabled for users who receive the Reports view. XE "Reports v iew:Acuity report (standard)" XE "Acuity report" Acuity Report: this report displays statistics that measure patient workload for each acuity level. For the date-and-time range you select, statistics show the number of patients who fell into each acuity category, the number of patients in each category who were admitted, and the number in each category who were admitted to a VA facility. The Acuity report also provides the following average times for patients in each acuity category: Admission Decision (all facilities)Admission Decision (VA facilities)Admission Delay (VA facilities) Test sites found that this report times out for date ranges that cover a large number of visits (1,400 visits within a one-month range, for example). They recommend clicking Continue and toggling between the Display Board and Reports views to get data from extended time ranges. Also, if your site’s process results in a number of patients whom you’ve removed from the board using the Patient Name Entered in Error selection, you should correct the report’s total number of patients by subtracting the number of patients who were entered in error. Figure 26: The Acuity report. XE "Reports view:Delay report (standard)" XE "Delay report" Delay Report: this report presents information about patients whose emergency department stays exceeded the nationally recognized limit (six hours or 360 minutes). For each patient whose stay exceeded this limit, the Delay report displays available information in the following columns:IENTime InElapsedDispositionDelay ReasonMDAdmission Decision (Adm Dec)Admission Delay (Adm Delay)AcuityDiagnosisFigure 27: The Delay report.EDIS does not include in its Delay and Delay Summary reports patients whose emergency-department visits are not yet closed—regardless of the number of hours their visits have consumed. XE "Reports view:Delay Summary report (standard)" XE "Delay Summary report" Delay Summary Report: this report presents average visit and decision-to-admit times (and other important information) for the following three visit categories: All emergency department visitsAll visits that resulted in VA-facility admissionsAll visits that did not result in VA-facility admissions This report also presents acuity-based tallies for each applicable reason for delay. Again, if your site’s process results in a number of patients whom you’ve removed from the board using the Patient Name Entered in Error selection, you should subtract this number from the report’s total number of visits and from visits that didn’t result in VA-facility admissions. Figure 28: The Delay Summary report. XE "Reports view:ED BVAC Patients report (standard)" XE "ED BVAC Patients report" ED BVAC Patients: the ED BVAC (Emergency Department Behavioral VA Care) Patients report captures the following information for behavioral-health patients:Time InTime OutComplaintMDAcuityElapsedTriageDispositionAdmission Decision (Adm Dec)Admission Delay (Adm Delay)DiagnosisICD9 (ICD-9-CM codes for this report are greater than 290 and less than 316)This report also provides service-related information such as whether or not the patient is a Vietnam veteran, has been exposed to Agent Orange, has a VA pension, and so forth. Figure 29: The ED BVAC Patients report. XE "Reports view:Exposure report (standard)" XE "Exposure report" Exposure Report: this report identifies patients and staff who may have been in the emergency department when a contagious patient was present for treatment. To run the report, you enter the internal entry number (IEN) from the contagious patient’s Visit file (#9000010). EDIS then uses information in this file to compile lists of all patients and staff who were in the emergency department during the time of the contagious patient’s visit. Figure 30: The Exposure report. XE "Reports view:Missed Opportunities report (standard)" XE "Missed Opportunities report" Missed Opportunities Report: this report displays the following information about patients whose dispositions are AMA (left against medical advice), L (left without being treated or seen), or E (eloped):IENTime InComplaintMDAcuityElapsedTriageWaitDispositionAdmission Decision (Adm Dec) If your site assigns a nurse to left-without-being-seen (LWBS) callbacks, the nurse must either have access to the Xref report or the application’s Edit Closed view (to search for LWBS patients by Time In values). Figure 31: The Missed Opportunities report. XE "Reports view:Orders by Acuity report (standard)" XE "Orders by Acuity report" Orders by Acuity: for each acuity, this report tallies the number of medication, laboratory, imaging, consultation, and other orders emergency-department personnel placed during the date-and-time range you specify. Figure 32: The Orders by Acuity report. XE "Reports view:Patient Intake report (standard)" XE "Patient Intake report" Patient Intake Report: the Patient Intake report provides time-of-day and day-of-week statistics regarding the number of patients who visited the emergency department during the date and time range you enter. Columns contain day-of-week tallies cover the entire time-and-date range against which you run the report. For example, if the date range you enter includes two Tuesdays, the intersection of the Tue column and the 0700-0800 row displays the total number of patients who visited the emergency department on both Tuesdays between the hours of 7:00 a.m. and 8:00 a.m. The Total column contains a sum of all day-based totals across each time-based row. For example, in the 0700-0800 row, the Total column contains a sum of daily totals from the Sun through Sat columns. For each time-based row, the Avg/Day column presents an average that is based on the figure in the Total column and the total number of days in the date range you select. For example, if your date range is January 1, 2009 through January 31, 2009, the total number of days (the denominator) will be 31. The report’s Avg/Hour row contains an average that is based on the total number of visits in each day-based column divided by the total number of hours for each day in the search range you select. For example, in the Sun column, the application calculates the following average: the total number of Sunday visits (the value in the Total row, Sun column) divided by 24 (the number of hours in a day) multiplied by the number of Sundays in the date range you select.The Patient Intake report does not include maximum, minimum, and mean calculations. Figure 33: The Patient Intake report. XE "Reports view:Shift report" XE "Shift report" Shift Report: this report is limited to one day of reporting and presents a shift-based calculation of the following data categories: Carried over at Report StartNumber of New PatientsNumber of Patients DischargedNumber Dec (Decision) to Admit to VANumber Dec (Decision) to Admit to OtherNumber over Six HoursNumber Waiting for TriageNumber of Occupied BedsNumber of Missed OpportunitiesNumber Deceased Number With No DispositionCarry over to Next ShiftFigure 34: The Shift report. XE "Reports view:VA Admissions report (standard)" XE "VA Admissions report" VA Admissions Report: this report uses Disposition selections to identify patients who were admitted to VA facilities (VA wards, intensive care units [ICUs], telemetry, and observation wards, for example) during the time-and-date range you specify. The report contains available information in the following columns:IENTime OutComplaintMDAcuityDispositionAdm Dec (Admission Decision)Adm (Admission) DelayDiagnosesICD9The report also provides averages for patients who fall into each applicable VA-admission category.Figure 35: The VA Admissions report.Cross Reference and Provider ReportsEDIS also provides two restricted-access reports: the Patient XRef (Cross Reference) and Provider reports. Because these two reports contain personally identifying information, you need special security keys (in VistA) to access and run them XE "Reports view:Cross Reference (XRef) report (restricted)" XE "Cross Reference (XRef) report" XREF: this report provides a cross reference between the EDIS IEN and patient identifiers (including patients’ surname initials concatenated with the last four digits of their SSNs). Figure 36: The Patient XRef (Cross Reference) report. XE "Reports view:Provider report (restricted)" XE "Provider report" Provider: The Provider report lists the total number of patients each provider saw during the date and time range you specify. It also provides a by-shift and by-acuity count of patients, the time between each patient's emergency-department time in and his or her diagnosis, and the time between each patient’s provider assignment and his or her disposition.If the Provider report’s MD Assign to Dispo(sition) column contains only zeros, your site probably doesn’t require providers to enter a disposition before releasing patients. Figure 37: The Provider report. XE "Reports view:Running and viewing reports" XE "Running and viewing reports" Run and View ReportsSelect Reports on the application’s left-hand menu bar. Keyboard: use the <Tab> key to locate the left-hand menu bar. Use the <Up Arrow> or <Down Arrow> key to locate Reports. Use the <Spacebar> key to select Reports.Select a report from the Report list. Keyboard: use the <Tab> key to locate the Report list. Use the <Down Arrow> and <Up Arrow> keys to select a report from the list.Click the Calendar icon () and select a starting date for your report or type a starting date in the Start Date box using this format: mm/dd/yyyy. (The application automatically formats shorter dates. For example, if you type 8/8/09, the application reformats the date as 08/08/2009.) Keyboard: use the <Tab> key to locate the Start Date box.Select a starting time in the Start Time box (). Keyboard: use the <Tab> key to locate the hour selector in the Start Time box. Select a start-time hour using the <Down Arrow> and <Up Arrow> keys. Use the <Tab> key to locate the minutes selector in the Start Time box. Use the <Down Arrow> and <Up Arrow> keys to select start-time minutes.If you are running the Exposure report, type the contagious patient’s IEN in the visit IEN box. The Exposure report does not require a date range. Click the Calendar icon in the Stop Date area and select a stop date for your report or type a stop date in the Stop Date box. Keyboard: use the <Tab> key to locate the Stop Date box. The Shift and Exposure reports do not require stop dates. Select a stop time in the Stop Time box. Keyboard: use the <Tab> key to locate the hour selector in the Stop Time box. Use the <Down Arrow> and <Up Arrow> keys to select an hour. Use the <Tab> key to locate the minutes selector in the Stop Time box. Use the <Down Arrow> and <Up Arrow> keys to select stop-time minutes.Click Run Report. Keyboard: use the <Tab> key to locate the Run Report button and use the <Spacebar> key to select the button. If your reports contain negative numbers, the problem could lie with logic that EDIS’s reports functionality inherited from the class-three Syracuse application. Syracuse reporting logic assumes that users will enter information in a certain sequence. For example, the application assumes that users will assign a provider before entering a patient’s disposition. To calculate the time that elapsed between a patient’s provider assignment and disposition, the application subtracts provider-entry time from disposition-entry time. If users assign providers after they’ve entered dispositions, reports such as the Provider report will contain negative numbers.Negative numbers can also be a result of not-so-careful data entry. For example, suppose a patient’s stay began on July 10 at 11:00 p.m. and ended on July 11 at 1:00 a.m. Further, suppose someone mistakenly removed this patient from the board at 11:55 p.m. When correcting this error, if the user corrects the patient’s time-out hour-and-minute value, but neglects to update the date value, the patient’s time-out value will be chronologically before his or her time-in value, and EDIS will calculate the patient’s stay at -22 hours. When reports exceed your application window’s viewing capacity, the application includes a scroll bar, as it does in the following screen capture: REDACTED XE "Reports view:Printing reports" XE "Printing reports" Print ReportsTo print a report, click Print. The Print button is in the upper right-hand corner of the Reports view. Keyboard: use the <Tab> key to locate the Print button and use the <Spacebar> key to select it. The application displays your operating system’s print dialog. XE "Reports view:Exporting reports (restricted action)" XE "Exporting reports" Export ReportsClick Export. If you are authorized to export reports, you’ll find this link in the upper right-hand corner of the Reports view. Keyboard: use the <Tab> key to locate Export and use the <Spacebar> key to select it. In the Select location for download by dialog box, select a location for your exported report. Keyboard: use the <Tab> key to locate the Save in selector. Use the <Down Arrow> and <Up Arrow> keys to find a location for your exported report. Press the <Enter> key to select the location.In the File name box, type a name for your exported report. Keyboard: use the <Tab> key to locate the File name box. If you want to export the report as an Excel spreadsheet, append the .xls extension before saving. Click Save. Keyboard: use the <Tab> key to locate the Save button and use the <Spacebar> key to select it. The application displays a message informing you that your download is complete. Click Close to dismiss the message. Keyboard: use the <Spacebar> key to select the Close button. Figure 39: Exported Activity report in Microsoft Excel. XE "Configure view" Configure ViewThis view allows authorized users to create customized big-board (usually large LED or plasma) displays and configure the application to include locally meaningful pick lists. Specifically, the view provides subviews that allow you to configure:Room and area selectionsStatus, disposition, delay-reason, and source selectionsDisplay-board optionsColorsParametersRoom and Area ConfigurationsThe XE "Room / Area subview, Configure view" Room / Area subview enables you to:Add or configure rooms and areasSpecify display names for rooms and areasDetermine when the display board displays rooms and areasSelect a default status for patients who occupy specific rooms or areasMark rooms or areas inactive Select the occupancy category into which rooms and areas fall (multiple patient, single patient, and so forth)Indicate areas that contain two or more beds (for exposure reports)Specify the electronic white-board display on which rooms and areas appearConfigure background and text colors for rooms and areas XE "Room / Area subview, Configure view:Adding, configuring, and editing rooms and areas" XE "Adding, configuring, and editing rooms and areas" Add, Configure, and Edit Rooms and AreasFigure 40: The Configure view—Room / Area subview.Select the Room / Area subview. Keyboard: use the <Tab> key to locate the left-hand view-selection menu. Use the <Down Arrow> and <Up Arrow> keys to locate the Configure view. Use the <Spacebar> key to select this view. Use the <Tab> key to locate the Room / Area subview and use the <Spacebar> or <Enter> key to select it. Click Add Room/Area. The application displays the Room / Area Edit pane and adds a new placeholder row in the Rooms / Areas grid. Keyboard: use the <Tab> key to locate the Add Room/Area button and use the <Spacebar> key to select it.To edit an existing room or area, click the room or area in the Rooms / Areas grid. Keyboard: use the <Tab> key to locate the Rooms / Areas grid. Use the <Down Arrow> key to enter the grid, and use the <Down Arrow> and <Up Arrow> keys to select a room or area. In the Name box (Edit pane), replace the application’s placeholder name (new1) with the name of the room you want to add. The application does not support duplicate room or area names. Keyboard: use the <Tab> key to locate the Name box.In the Display Name box, replace the placeholder name (new1) with the name you want EDIS to display. Keyboard: use the <Tab> key to locate the Display Name box. The application does not support duplicate display names for rooms and areas. Select one of the following three options from the Display When list: Occupied, Always, or Never. Your selection determines when EDIS displays the room or area on the large electronic whiteboard display. Keyboard: use the <Tab> key to locate the Display When list. Use the <Down Arrow> and <Up Arrow> keys to select an option from this list.To configure a default status for patients who are assigned to the new room (optional), select a status from the Default Status list. (Sites can configure their own selections for this list.) Keyboard: use the <Tab> key to locate the Default Status list. Use the <Down Arrow> and <Up Arrow> keys to select a default status from the list. If the new room or area is currently inactive, select the Inactive? checkbox. Keyboard: use the <Tab> key to locate the Inactive? checkbox. Use the <Spacebar> key to select (or cancel the selection of) the Inactive? checkbox. From the Category list, select the occupancy category into which the room or area falls. Keyboard: use the <Tab> key to locate the Category list. Use the <Down Arrow> and <Up Arrow> keys to select an occupancy category from the list. If a room or area contains two or more beds, type in the Shared Name box a name that associates the beds. For example, if area OBS contains two beds, OBS-1 and OBS-2, configure a room or area for each bed and type OBS in the Shared Name box for both OBS-1 and OBS-2. Keyboard: use the <Tab> key to locate the Shared Name box.If your site uses more than one large electronic whiteboard display, type in the Use Board box the name of the display board on which the room or area will appear. All patients appear on the application’s main electronic whiteboard display. Keyboard: use the <Tab> key to locate the Use Board box.Select the Use Color check box to configure a text and/or background color for the room or area. (Optional. See section 13.1.1.1, “Configuring Color for Rooms and Areas.”)To dismiss the Edit pane and view all columns in the Rooms / Areas grid, click All Columns. Keyboard: use the <Tab> key to locate the All Columns button and use the <Spacebar> key to select it. Click Save Room / Area Changes to save your changes. The application displays a message that tells you it has successfully saved your changes. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate the Save Room / Area Changes button. Use the <Spacebar> key to select the Save Room / Area Changes button. Use the <Tab> key to locate the Close button, use the <Spacebar> key to select the Close button. XE "Room / Area subview, Configure view:Configuring colors for rooms and areas" Configuring Colors for Rooms and AreasThe application allows you to configure text and background colors for rooms and areas. Select the Use Color checkbox. Keyboard: use the <Tab> key to locate the Use Color check box. Use the <Spacebar> key to select (or cancel the selection of) this check box.To configure a color for text, click the color-selection box labeled Text. EDIS displays a color-selection grid ( ). Click a color in the grid to select it as a text color. General keyboard actions are not available for this step; however, JAWS users can type hexadecimal color codes for text.To configure a background color, click the color-selection box labeled Back. EDIS displays a color-selection grid. Click a color in the grid to select it as a background color. General keyboard actions are not available for this step; however, JAWS users can type hexadecimal color codes for backgrounds.Click Save Room / Area Changes to save your color selections. Keyboard: use the <Tab> key to locate the Save Room / Area Changes button and use the <Spacebar> key to select it. Colors you configure for room and area assignments will not appear on the display board unless colors (in general) are enabled for room and area selections in the Configuration view’s Display Board subview. XE "Room / Area subview, Configure view:Specifying the order of rooms and areas" XE "Specifying the order of rooms and areas" Specifying the Order of Rooms and AreasUse a drag and drop operation to change the order of rooms and areas in the Rooms / Areas grid. EDIS bases the order of its Room / Area selection lists on the order of rooms and areas in the Rooms / Areas grid. Keyboard actions are not available for drag-and-drop operations. XE "Configure view:Display board configuration" XE " Display board configuration" Display Board ConfigurationsFigure 41: The Configure view—Display Board subview.The Display Board subview enables you to: Add a new large electronic whiteboard display Add or remove display-board columnsEdit column headersIdentify information upon which you want to base cell colors in display-board columnsIdentify information upon which you want to base colors in display-board rowsReposition and resize display-board columnsSelect optimal display sizesConfigure the display’s font size and scroll-delay timeCompress (squish) all data rows into a single, no-scroll view (if possible)EDIS enables you to configure each display board separately. Simply select the board you want to configure in the Board Name list. The application displays editable information about the board in the Board Properties pane. XE "Adding a new display board" XE "Display Board subview, Configure view:Adding a new display board" Add a New Display BoardEDIS enables you to create multiple large electronic whiteboard displays. However, be advised: you cannot delete display boards after you’ve saved them. Click Add Board. EDIS adds a placeholder name (new1) in the Board Name list and the Board Name box, which is located in the Board Properties pane. Keyboard: use the <Tab > key to locate the Add Board button and use the <Spacebar> key to select the button. In the Board Name box, replace the placeholder name with the name you want to use for this new display board. Each display board must have a unique name. Keyboard: use the <Tab> key to locate the Board Name box. (Optional) In the Row Color Based On list, select a display-board item upon which you want to base row colors. Keyboard: use the <Tab> key to locate the Row Color Based On list. Use the <Down Arrow> and <Up Arrow> keys to select an item from the list. In the Display Size list, select the screen size of your display board. Display sizes are site configurable. If the Display Size list does not contain your new board’s screen size, ask your site’s CAC or IRM staff to add the size in VistA. Keyboard: use the <Tab> key to locate the Display Size list. Use the <Down Arrow> and <Up Arrow> keys to select a display size from the list. In the Font Size spin box, type or select a font size for your new display board. Available font sizes range from six to 36 points. The Preview Display Board pane dynamically displays your font choices. Keyboard: use the <Tab> key to locate the Font Size box. Type a font size, or use the <Down Arrow> and <Up Arrow> keys to select a font size.(Optional) Select the Squish Rows To Fit (if possible) check box. This selection allows EDIS to compress all data rows to completely fit within your site’s display screen, if this is possible. To ensure readability, the application compresses data only down to a row size of 18 points and a font size of nine points. If, after applying the maximum compression, your site’s data will still not fit within a single display view, the application applies scrolling functionality and restores the display board’s font size to the value in the Font Size spin box. Keyboard: use the <Tab> key to locate the Squish (if possible) checkbox. Use the <Spacebar> key to select—or cancel the selection of—the checkbox. In the Scroll Delay spin box, type or select a scroll-delay time (in seconds). The application automatically activates scrolling when the screen’s real estate is not sufficient to display all of the patients who are currently on the Active Patients list. The delay-time setting determines how long screen contents remain stationary. For example, suppose your display can accommodate only 20 patients and 25 patients are currently on the list. Further, suppose that the EDIS scroll-delay time is set at five seconds. In this case, EDIS displays the first 20 patients for five seconds, then scrolls to display the remaining five patients for five seconds, and so forth. Keyboard: use the <Tab> key to locate the Scroll Delay box. Type a delay time or use the <Up Arrow> and <Down Arrow> keys to select a delay time. EDIS refreshes the display board every 30 seconds. Each refresh resets the display-board view. Set scroll-delay intervals that allow the application to display all patients within the span of a single refresh cycle. (JAWS users can disable automatic refresh functionality and manually refresh the display board by pressing the <F7> key. However, automatic refresh is disabled only when JAWS is running.) XE "Display Board subview, Configure view:Adding display-board columns" XE "Adding display-board columns" Add Display Board ColumnsDisplay boards can include any of the following columns:Room / Bed: the rooms, beds, and areas associated with the display boardPatient Name: the patients’ surnamesPatient X9999: the first initials of the patients’ surnames concatenated with the last four digits of their Social Security numbersVisit Created: checkmarks that indicate EDIS has created visits for the patients in CPRS or blank spaces that indicate EDIS has not created visitsComplaint: the patients’ display-board complaintsComments: comments users have entered via the Update viewProvider Initials: the initials of the providers users have selected via the Triage, Update, or Disposition viewsResident Initials: the initials of the residents users have selected via the Triage , Update, or Disposition viewsNurse Initials: the initials of the nurses users have selected via the Triage and Update viewsAcuity: the acuities users have entered via the Triage viewStatus: the statuses users have entered via the Update and Disposition viewsLab Active/Complete: the number of active laboratory orders associated with the patients’ emergency-department visits over the number of completed laboratory ordersImaging Active/Complete: the number of active imaging orders associated with the patients’ emergency-department visits over the number of completed imaging ordersNew (Unverified) Orders: the number of unverified orders associated with the patients’ emergency-department visits (for sites using CPRS 26, EDIS decrements this number when unverified orders are completed; for sites using CPRS 27, EDIS decrements this number when unverified orders are verified)Total Minutes: the number of minutes from patients’ time-in values (the times users added patients to—or identified them in—EDIS) to the presentMinutes at Location: the number of minutes patients have been assigned to their present locationsFigure 42: The Add Column list.Click to open the Add Column list. Keyboard: use the <Tab> key to locate the Add Column list. Press the <Spacebar> key to open the list. Click to select a column name from the Add Column list. The Preview Display Board pane dynamically displays columns as you add them. Keyboard: use the <Down Arrow> and <Up Arrow> keys to locate the name of the column you want to add. Use the <Spacebar> or <Enter> key to select the column.Repeat steps 1 and 2 as necessary. Keyboard: the application maintains its focus on the Add Column list, so you won’t need to locate the Add Column list t anew with each new column addition. Simply press the <Spacebar> key to reopen the list. After you add columns, you can specify their order using a drag-and-drop operation (see Section 13.2.4, “Specify the Order of Display Board Columns”). Keyboard operations are not available for post-addition column ordering. If you exclusively use keyboard actions, please add columns in the order in which you want them to appear on your large electronic whiteboard display. XE "Configuring or editing display-board columns" XE "Display Board subview, Configure view:Configuring or editing display-board columns" Configure or Edit Display Board ColumnsIn the Selected Columns list, click the column whose properties you want to configure or edit. Keyboard: use the <Tab> key to locate the Selected Columns list. Use the <Down Arrow> key to enter the list. Use the <Down Arrow> and <Up Arrow> keys to locate the column you want to configure.In the Header box, which is located in the Column Properties pane, replace the application’s default or current header (optional). Keyboard: use the <Tab> key to locate the Header box. Select an item in the Color Based On list (optional). Your selection here determines the criteria the application uses to display color configurations in big-board display columns. The application gives preference to colors you configure for columns over colors you configure for rows. List items include: Status / Acuity, Status, Acuity, Room / Bed, Provider, Resident, Nurse, Urgency – Lab, Urgency – Radiology, Total Elapsed Minutes, Minutes at Location, Minutes for Lab Order, Minutes for Imaging Order, and Minutes for Unverified Order. Although you configure color selections in the Assign Staff view and the Colors and Room / Area subviews, the Display Board subview of the Configuration view is where you determine which of these colors the board displays and where it displays them.Your selection determines which color or colors appear on the display board for the column you’ve selected. For example, suppose you select the Status column. Then suppose you click this column’s Color Based On list and select Acuity. In this case, the board will display in its Status column colors you have configured for acuity. XE "Arranging display-board columns" XE "Display Board subview, Configure view:Arranging display-board columns" Specify the Order of Display Board ColumnsYou can specify the order of large electronic whiteboard display columns by using a drag-and-drop operation in either the Preview Display Board pane or the Selected Columns list. To perform a drag-and-drop operation, click a column header and, without releasing your mouse button, move the header to its new location. Release the mouse button. Keyboard actions are not available for drag-and-drop operations. To reorder columns using your keyboard, remove columns in the Selected Columns list and re-add them in the order in which you want them to appear on the display. XE "Resizing display-board columns" XE "Display Board subview, Configure view:Resizing display-board columns" Resize Display Board ColumnsYou resize columns in the Preview Display Board pane by using a drag-and-drop operation (keyboard actions are not available): Point your mouse at the border of the column you want to resize. When your mouse pointer becomes a slider ( ) hold down your right mouse button and drag the boarder to resize the column.Release your mouse button. XE "Removing display-board columns" XE "Display Board subview, Configure view:Removing display-board columns" Remove Display Board ColumnsYou can remove columns from the Selected Columns list in any of the following ways: Remove a single column: click an individual column in the Selected Columns list and press the <Delete> key. Keyboard: use the <Tab> key to locate the Selected Columns list. Use the <Down Arrow> and <Up Arrow> keys to select the column you want to remove. Press the <Delete> key to remove the column.Remove a group of columns: select a group of columns in the Selected Columns list by clicking the first column in the group, then pressing and holding down the <Ctrl> key as you click the remaining columns. Release the <Ctrl> key and press the <Delete> key to remove the group. Keyboard: use the <Tab> key to locate the Selected Columns list. Use the <Down Arrow> and <Up Arrow> keys to select the first column in the group. Press and hold down the <Ctrl> key while using the <Down Arrow> and <Up Arrow> keys to locate additional columns in the group. Press the <Spacebar> key to select each of these columns. Release the <Ctrl> key and press the <Delete> key to delete the group. Remove a range of columns: select a range of columns in the Selected Columns list by clicking the first column in the range, then pressing and holding down the <Shift> key as you click the last column. Release the <Shift> key and press the <Delete> key to remove the range. Keyboard: use the <Tab> key to locate the Selected Columns list. Use the <Up Arrow> and <Down Arrow> keys to locate the first column in the range. Press and hold down the <Shift> key while using the <Up Arrow> or <Down Arrow> key to select the remaining columns in the range. Release the <Shift> key and press the <Delete> key to remove the range. XE "Saving display-board configurations" XE "Display Board subview, Configure view:Saving display-board configurations" Save Display Board Configuration ChangesClick Save Display Board Changes. EDIS displays an Alert message to confirm that it has successfully saved your changes. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate the Save Display Board Changes button. Press the <Spacebar> key to select the button. Use the <Tab> key to locate the Close button, and use the <Spacebar> key to select it. XE "Colors subview, Configure view:Configuring colors" XE "Configuring colors" Configure Colors Figure 43: The Configure view—Colors subview, Status / Acuity selected.The Colors subview enables you to configure colors for the following items: Status / AcuityStatusAcuityUrgency – LabUrgency – RadiologyTotal Elapsed MinutesMinutes at LocationMinutes for Lab OrderMinutes for Imaging OrderMinutes for Unverified OrderYou can configure colors for rooms and areas on the Room / Area subview. Configure colors for emergency-department staff on the Assign Staff view. XE "General instructions for configuring colors" XE "Colors subview, Configure view:General instructions for configuring colors" Configure Colors (General Instructions)Use Color Check Box SelectedUse Color Check Box Not SelectedFigure 44: The Use Color check boxYou can configure colors for any tracking item for which EDIS displays the Use Color check box:Select the Use Color checkbox. The application displays the Text and Back color-selection boxes. Keyboard: use the <Tab> key to locate the Use Color check box. Use the <Spacebar> key to select it. To configure a text color, click the Text box. The application displays the color-selection grid (). Click a color within the grid to select it as the text color. Keyboard actions are not available for this step; however, JAWS users may type in a hexadecimal color code.To configure a background color, click the Back box. EDIS displays the color-selection grid. Click a color within the grid to select it as the background color. Keyboard actions are not available for this step; however JAWS users may type in a hexadecimal color code. XE "Configuring colors for status and acuity values" XE "Colors subview, Configure view:Configuring colors for status and acuity values" Configure Colors for Status and Acuity ValuesYou can configure colors for all status values. The following initial values ship with the application: Admitted Awaiting TriageED Boarding [Hold]ED Observation UnitED PatientEn Route/PrearrivalDischargedYou can also configure colors for the following acuity values. (The application supports Emergency Severity Index [ESI] acuity values.)1 (most urgent)2 345 (least urgent)In addition, you can use the Status / Acuity selection to configure colors for the combined set of these status and acuity values. Color-map selections in the Colors subview must match at least one color selection in the Display Board subview. For example, if you configure colors for the Status / Acuity selection in the Colors subview, select Status / Acuity in the Colors Based On column or Row Color list in the Display Board subview. Also note: if you configure colors for the Status/Acuity selection and also for the Acuity and/or Status selections, the application will display the colors you configured for Status / Acuity. In the Available Color Maps list, select Status, Acuity, or Status / Acuity. EDIS displays the Colors for Status, Colors for Acuity, or Colors for Status / Acuity grid, respectively. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> or <Up Arrow> keys to select Status / Acuity, Status, or Acuity.To configure colors for a value listed in the corresponding grid, select the value. Keyboard: use the <Tab> key to locate the grid. Use the <Down Arrow> and <Up Arrow> keys to select a value within the grid.Click the Use Color checkbox and follow the instructions in Section 13.3.1 “Configure Colors (General Instructions).” Keyboard: use the <Tab> key to locate the Use Color check box. Use the <Spacebar> key to select the check box.Repeat steps 1–3 to configure colors for additional values.Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Urgency - Lab values" XE "Colors subview, Configure view:Configuring colors for Urgency - Lab values" Configure Colors for Urgency – Lab ValuesFigure 45: The Colors for Urgency - Lab grid.You can configure colors for the following values:No OrdersActive OrdersSTAT OrdersIn the Available Color Maps list, select Urgency - Lab. EDIS displays the Colors for Urgency - Lab grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> key to enter the list, and use the <Down Arrow> or <Up Arrow> keys to locate Urgency – Lab.To configure colors for a value listed in the grid, select the value, then select the Use Color check box. Keyboard: use the <Tab> key to locate the Urgency – Lab grid. Use the <Down Arrow> and <Up Arrow> keys to select a value in the grid. Use the <Tab> key to locate the Use Color checkbox, and use the <Spacebar> key to select it.Follow the steps in Section 13.3.1 “Configure Colors (General Instructions)” to configure colors for the value.Repeat steps 1–3 to configure colors for additional values.Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Urgency - Radiology values" XE "Colors subview, Configure view:Configuring colors for Urgency - Radiology values" Configure Colors for Urgency – Radiology ValuesYou can configure colors for the following values:No OrdersActive OrdersSTAT OrdersFigure 46: Colors for Urgency – Radiology grid.In the Available Color Maps list, select Urgency - Radiology. EDIS displays the Colors for Urgency – Radiology grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Urgency – Radiology. To configure colors for a value listed in the Colors for Urgency – Radiology grid, select the value, then select the Use Color checkbox. Keyboard: use the <Tab> key to locate the Colors for Urgency – Radiology grid. Use the <Down Arrow> and <Up Arrow> keys to select a value. Use the <Tab> key to locate the Use Color checkbox and use the <Spacebar> key to select it. Follow the steps in Section 13.3.1 “Configure Colors (General Instructions)” to configure colors for the value.Repeat steps 1–3 to configure colors for additional values.Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Total Elapsed Minutes values" XE "Colors subview, Configure view:Configuring colors for Total Elapsed Minutes values" Configure Colors for Total Elapsed MinutesThe application measures total elapsed minutes from patients’ Time In values. Figure 47: Configure colors for Total Elapsed Minutes selection.Select Total Elapsed Minutes in the Available Color Maps list. The application displays the Colors for Total Elapsed Minutes grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Total Elapsed Minutes.To add a time value to the Starting at Elapsed Minute column, click Add. The application displays the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Add button and use the <Spacebar> key to select it.Type a starting value in the Starting at Elapsed Minute box. EDIS uses this value to determine when to display your color configuration. Keyboard: use the <Tab> key to locate the Starting at Elapsed Minute box.To associate a color with this value, select the Use Color checkbox and follow the steps in Section 13.3.1 “Configure Colors (General Instructions).”Repeat steps 1 through 4 to configure colors for additional Starting at… minutes as necessary. Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Minutes at Location values" XE "Colors subview, Configure view:Configuring colors for Minutes at Location values" Configure Colors for Minutes at LocationThe application measures elapsed times from patients’ most recent room assignments. Figure 48: The Colors for Minutes at Location grid.Select Minutes at Location in the Available Color Maps list. The application displays the Colors for Minutes at Location grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Minutes at Location.To add a time value to the Starting at Elapsed Minute column, click Add. The application displays the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Add button.Type a starting value in the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Starting at Elapsed Minute box.To associate a color with this value, select the Use Color checkbox and follow the steps in Section 13.3.1 “Configure Colors (General Instructions).”Repeat steps 1 through 4 to configure colors for additional Starting at… values as necessary. Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Minutes for Lab Order values" XE "Colors subview, Configure view:Configuring colors for Minutes for Lab Order values" Configure Colors for Minutes for Lab OrderValues measure times from when orders were released to the laboratory. Figure 49: The Colors for Minutes for Lab Order grid.Select Minutes for Lab Order in the Available Color Maps list. The application displays the Colors for Minutes for Lab Order grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Minutes for Lab Order.To add a time value to the Starting at Elapsed Minute column, click Add. The application displays the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Add button.Type a starting value in the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Starting at Elapsed Minute box.To associate a color with this value, select the Use Color checkbox and follow the steps in Section 13.3.1 “Configure Colors (General Instructions).”Repeat steps 1 through 4 to configure colors for additional starting-at minutes as necessary. Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Minutes for Imaging Order values" XE "Colors subview, Configure view:Configuring colors for Minutes for Imaging Order values" Configure Colors for Minutes for Imaging OrderValues measure time from when orders are released to radiology. Figure 50: The Colors for Minutes for Imaging Order grid.Select Minutes for Imaging Order in the Available Color Maps list. The application displays the Colors for Minutes for Imaging Order grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Minutes for Imaging Order.To add a time value to the Starting at Elapsed Minute column, click Add. The application displays the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Add button and use the <Spacebar> key to select the button.Type a starting value in the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Starting at Elapsed Minute box.To associate a color with this value, select the Use Color checkbox and follow the steps in Section 13.3.1 “Configure Colors (General Instructions).”Repeat steps 1 through 4 to configure colors for additional Starting at… values as necessary. Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Configuring colors for Minutes for Unverified Orders values" XE "Colors subview, Configure view:Configuring colors for Minutes for Unverified Orders values" Configure Colors for Minutes for Unverified OrdersValues measure time from when orders are released. Figure 51: The Colors for Minutes for Unverified Order grid.Select Minutes for Unverified Order in the Available Color Maps list. The application displays the Colors for Minutes for Unverified Orders grid. Keyboard: use the <Tab> key to locate the Available Color Maps list. Use the <Down Arrow> and <Up Arrow> keys to select Minutes for Unverified Order.To add a time value to the Starting at Elapsed Minute column, click Add. The application displays the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Add button and press the <Spacebar> key to select it.Type a starting value in the Starting at Elapsed Minute box. Keyboard: use the <Tab> key to locate the Starting at Elapsed Minute box.To associate a color with this value, select the Use Color checkbox and follow the steps in Section 13.3.1 “Configure Colors (General Instructions).”Repeat steps 1 through 4 to configure colors for additional Starting at… values as necessary. Click Save Color Changes to save your color configurations. The application displays an Alert message to inform you that it has saved your color selections. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate Save Color Changes and use the <Spacebar> key to select it. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. XE "Parameters subview, Configure view" Configure ParametersFigure 52: The Configure view—Parameters subview.The Parameters subview allows you to set the following parameters: Show residents on entry form—This parameter enables sites that have residents to include them on the application’s data entry form. Fields for making and editing resident selections are available on the Triage, Update, Disposition, and Edit Closed views.Diagnosis is required before removing a patient—When sites select this parameter, EDIS requires emergency-department personnel to enter diagnoses as a precondition to removing patients from the display board—unless the patient’s disposition is one of the following: Patient Name Entered in Error, Left Without Being Treated/Seen, or Sent to Nurse Eval / Drop In Clinic.Diagnosis must be coded as ICD—When sites select this parameter, the application uses VistA’s ICD-9-CM search for all diagnosis entries. When sites do not select this parameter, the application uses a free-text field to record diagnoses. Disposition is required before removing patient—When sites select this parameter, the application requires emergency department personnel to enter dispositions before removing patients from the display board.Delay reason is required for visits exceeding [site-specified] minutes—When sites select this parameter, the application does not allow users to remove patients whose stays have exceeded a specific number of minutes without first entering a reason for delay—except when the patient’s disposition indicates that he or she has been assigned to an observation ward. Arriving Ambulance Room/Area is—This parameter enables sites to select a default room or area for patients who are arriving by ambulance or other emergency-transport vehicles. Default Room/Area is—This parameter enables sites to select a default room or area. The Parameters subview also enables sites to specify shift start times and durations. The application uses this information to pull data for shift reports. XE "Including residents on the entry form" XE "Parameters subview, configure view:Including residents on the entry form" Include Residents on Entry FormSelect the Show residents on entry form checkbox. Keyboard: use the <Tab> key to locate the Show residents on entry form checkbox. Use the <Spacebar> key to select the checkbox. Clear the checkbox to remove the resident-selection list from the entry form. Keyboard: use the <Spacebar> key to clear the checkbox. XE "Requiring diagnoses" XE "Parameters subview, Configure view:Requiring diagnoses” Require a DiagnosisSelect the Diagnosis is required before removing patient checkbox. Keyboard: use the <Tab> key to locate the Diagnosis is required before removing patient checkbox. Use the <Spacebar> key to select the checkbox. Clear the checkbox to remove the requirement. Keyboard: use the <Spacebar> key to clear the checkbox. XE "Requiring ICD-9-CM or free-text diagnoses" XE "Parameters subview, Configure view:Requiring ICD-9-CM or free-text diagnoses" Require ICD-9-CM or Free Text DiagnosesTo require ICD-9-CM diagnoses, select the Diagnosis must be coded as ICD checkbox. Keyboard: use the <Tab> key to locate the Diagnosis must be coded as ICD checkbox. Use the <Spacebar> key to select the checkbox. To require free-text diagnoses, do not select—or clear the selection of—the Diagnosis must be coded as ICD checkbox. Keyboard: use the <Spacebar> key to clear the selection of the checkbox. XE "Requiring a disposition to remove patients from the board" XE "Parameters subview, Configure view:Requiring a disposition to remove patients from the board" Require Disposition to Remove PatientsSelect the Disposition is required before removing patient checkbox. Keyboard: use the <Tab> key to locate the Disposition is required before removing patient checkbox. Use the <Spacebar> key to select the checkbox. To remove the requirement, clear the checkbox. Keyboard: use the <Spacebar> key to clear the checkbox. XE "Requiring a reason for delay" XE "Parameters subview, Configure view:Requiring a reason for delay" Require a Reason for DelaySelect the Delay reason is required for visits exceeding …minutes checkbox. In the minutes box, type or select a number of minutes after which the application should require a reason for delay. Keyboard: use the <Tab> key to locate the Delay reason is required for visits exceeding…minutes checkbox. Use the <Spacebar> key to select the checkbox. Use the <Tab> key to locate the minutes box. Type a number of minutes or use the <Up Arrow> or <Down Arrow> key to select a number of minutes. The national visit limit for emergency departments is currently six hours (360 minutes). Clear the checkbox to remove the requirement. Keyboard: use the <Spacebar> key to clear the checkbox. XE "Configuring shift parameters" XE "Parameters subview, Configure view:Configuring shift parameters" Configure Shift ParametersIn the First shift begins at box, type the time (in hours and minutes—hh:mm) your site’s first shift begins. Keyboard: use the <Tab> key to locate the First shift begins at box. In the Shift duration is…hours and minutes boxes, type or select the hours and minutes that mark the duration of your site’s shifts. Keyboard: use the <Tab> key to locate the Shift duration is…hours and minutes boxes. Type hours and minutes or use the <Up Arrow> or <Down Arrow> key to select hours and minutes. XE "Setting a default room or area for patients arriving by ambulance" XE "Parameters subview, Configure view:Setting a default room or area for patients arriving by ambulance" Set a Default Room or Area for Patients Arriving by AmbulanceSelect a room or area from the Arriving Ambulance Room/Area is list. Keyboard: use the <Tab> key to locate the Arriving Ambulance Room/Area is list. Use the <Up Arrow> or <Down Arrow> key to select a default room or area from the list. XE "Setting a default room or area" XE "Parameters subview, Configure view:Setting a default room or area" Set a Default Room or AreaSelect a room or area from the Default Room/Area is list. Keyboard: use the <Tab> key to locate the Default Room/Area is list. Use the <Up Arrow> or <Down Arrow> key to select a default room or area from the list. XE "Saving parameter selections" XE "Parameters subview, Configure view:Saving parameter selections" Save Parameter SelectionsClick Save Parameter Changes. The application displays an Alert message to inform you that it has successfully saved your changes. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate the Save Parameter Changes button. Use the <Spacebar> key to select the button. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it.Some parameter settings require you to log out of the application and log back in. For example, if you select the Diagnosis must be coded as ICD checkbox, you must log out and log back in to see the change on the application’s Disposition view. Likewise, after selecting the Show residents on entry form checkbox, you must log out and log back in to see resident lists on the application’s Update view. XE "Selections subview, Configure view" XE "Adding choices to selection lists" Add Choices to Selection ListsFigure 53: Configure view—Selections subview.The Selections subview enables you to add locally meaningful choices to selection lists that ship with EDIS. Specifically, you can add selections to the following lists: Status: the application ships with the following statuses:Admitted Awaiting TriageDischargedED Boarding [Hold]ED Observation UnitED PatientEn Route/PrearrivalDisposition: the application ships with the following dispositions:Admitted to VA WardAdmitted to TelemetryAdmitted to ICUAdmitted to PsychiatryHomeAMA (left against medical advice)Left Without Being Treated/SeenElopedTransferred to VA FacilityTransferred to non-VA FacilityDeceasedSent to Nurse Eval / Drop In ClinicSent to Urgent Care ClinicPatient Name Entered in ErrorDelay Reason: the application ships with the following reasons for delay: Obtain Inpatient BedED to Hospital BedObtain Imaging ResultsObtain Imaging StudiesObtain Drugs/PharmacologyObtain Lab ResultsObtain Lab StudiesObtain Medical SuppliesArrange Emergency SurgeryObtain ConsultantOn-call StaffPatient Transport HomeOvercrowding of EDPatient Transport OtherObtain Accepting PhysicianObtain EscortAdmitting Physician EvaluationAdmit Physician Writing DispoPatient Admitted to ObservationED Staff LimitsED Physician LimitsInterfacility TransferObtain Ambulance ServicesSource: the application ships with the following sources: Non-referredOn-site ClinicOn-site Nursing HomeVA Clinic, Off-siteVA Nursing Home, Off-siteNon-VA Clinic/OfficeNon-VA Nursing HomeTransfer, OtherThe EDIS technical working group (TWG) and technical advisory group (TAG) have vetted these default lists. When sites add selections, the application denotes them by displaying the word local in the subview’s National Name column. XE "Adding status, disposition, delay reason, and source selections to selection lists" XE "Selections subview, Configure view:Adding status, disposition, delay reason, and source selections to selection lists" Add Status, Disposition, Delay Reason, and Source SelectionsSelect Status, Disposition, Delay Reason, or Source in the Selection List. The application displays the Selections for Status, Selections for Disposition, Selections for Delay Reason, or Selections for Source grid, respectively. (Definitions for nationally released sources are available in section 4.1.5 of this guide; definitions for nationally released statuses are available in section 6.2.1; definitions for nationally released dispositions are available in section 8.1.1; and definitions for nationally released delay reasons are available in section 8.2.1.) Keyboard: use the <Tab> key to locate the Selection List. Use the <Down Arrow> and <Up Arrow> keys to select Status, Disposition, Delay Reason, or Source. Click Add. The application displays the Edit Selection Item pane. Keyboard: use the <Tab> key to locate the Add button and use the <Spacebar> key to select the button.In the Name box (Edit Selection Item pane), type a name for the selection you want to add. Keyboard: use the <Tab> key to locate the Name box. In the Abbreviation box , type an abbreviation for the item you want to add. EDIS uses this abbreviation for its large electronic whiteboard display. Keyboard: use the <Tab> key to locate the Abbreviation box.Status selection additions: if applicable, type the letter A (for admitted) or the letter O (for observation), or both in the Flags box. EDIS uses these flags for reporting and to determine whether or not it should require a reason for delay when emergency-department stays exceed site-specified time limits. Keyboard: use the <Tab> key to locate the Flags box.Disposition selection additions: if applicable, type VA (for VA admission), A (for admitted), or M (for missed opportunity) in the Flags box. EDIS uses these flags for reporting. Keyboard: use the <Tab> key to locate the Flags box.(Optional) If you want to inactivate the new item, select the Inactive check box. The application does not include inactive items on its selection lists. Keyboard: use the <Tab> key to locate the Inactive check box and use the <Spacebar> key to select it.(Optional) Change the order in which EDIS displays list selections in its data views by using a drag-and-drop operation to reorder selections in the Selections for Status, Selections for Disposition, Selections for Delay Reason, or Selections for Source lists. Keyboard instructions are not available for this step.Click Save Selection List Changes to save your additions (or edits). EDIS displays an Alert message to tell you it successfully saved your changes. Click Close to dismiss this message. Keyboard: use the <Tab> key to locate the Save Selection List Changes button and use the <Spacebar> key to select the button. Use the <Tab> key to locate the Close button and use the <Spacebar> key to select it. Index INDEX \e "" \c "2" \z "1033" Activity report48Acuity entries28Acuity report49Add patientAdd information to the Patient Information pane19Adding unidentified patients19, 26Ambulance Is Arriving, Patient Name Is Unknown19, 26Enter Name, Patient Is Not in VistA18Enter Name, Patient Is Not in VistA25Search for Patient in VistA18, 24Triage view24Add patientsIdentify patients21Add triage information28Adding a new display board64Adding choices to selection lists82Adding display-board columns65Adding EDIS to IE Favorites7Adding providers, residents, and nurses to staff pick lists45Adding status, disposition, delay reason, and source selections to selection lists84Adding, configuring, and editing rooms and areas61Adobe Flash Player3Application timeouts5Arrange columns9Arranging display-board columns68Assign Staff view9, 45Adding providers, residents, and nurses to staff pick lists45Configuring colors for providers, residents, and nurses46Removing providers, residents, and nurses from staff pick lists46Clinic entries29Colors subview, Configure viewConfiguring colors70Configuring colors for Minutes at Location values75Configuring colors for Minutes for Imaging Order values77Configuring colors for Minutes for Lab Order values76Configuring colors for Minutes for Unverified Orders values78Configuring colors for status and acuity values71Configuring colors for Total Elapsed Minutes values74Configuring colors for Urgency - Lab values72Configuring colors for Urgency - Radiology values73General instructions for configuring colors70Complaint for display board entries28Configure view9, 61Display board configuration64Configuring colors70Configuring colors for Minutes at Location values75Configuring colors for Minutes for Imaging Order values77Configuring colors for Minutes for Lab Order values76Configuring colors for Minutes for Unverified Orders values78Configuring colors for providers, residents, and nurses46Configuring colors for status and acuity values71Configuring colors for Total Elapsed Minutes values74Configuring colors for Urgency - Lab values72Configuring colors for Urgency - Radiology values73Configuring or editing display-board columns67Configuring shift parameters81Creating a visit in CPRS32Creating visits in CPRS29Cross Reference (XRef) report57Data grids9Arrange columns9Resize columns9Sort columns10Definitions for source selections (national)20NHCI20Non-VA Clinic/Office20Non-VA Nursing Home20On-Site Clinic20On-Site Nursing Home20Self-Referred20Transfer, Other20VA Clinic, Off-Site20VA Nursing Home, Off-Site20Definitions for status selections (national)29Admitted29Awaiting Triage29Discharged29ED Boarding [Hold}29ED Observation Unit29ED Patient29En Route/Prearrival29Delay reason definitions35Admit Physician Writing Dispo35Admitting Physician Evaluation35Arrange Emergency Surgery37ED Physician Limits37ED Staff Limits37ED to Hospital Bed36Interfacility Transfer36Obtain Accepting Physician35Obtain Ambulance Services36Obtain Consultant36Obtain Drugs/Pharmacology37Obtain Escort36Obtain Imaging Results36Obtain Imaging Studies36Obtain Inpatient Bed36Obtain Lab Results37Obtain Lab Studies37Obtain Medical Supplies37On-call Staff37Overcrowding of ED37Patient Admitted to Observation36Patient Transport Home36Patient Transport Other37Delay report50Delay Summary report51Display board configuration64Display Board subview, Configure viewAdding a new display board64Adding display-board columns65Arranging display-board columns68Configuring or editing display-board columns67Removing display-board columns68Resizing display-board columns68Saving display-board configurations69Display Board view8Disposition definitions (national)34Admitted to ICU34Admitted to Psychiatry34Admitted to Telemetry35Admitted to VA Ward34AMA34Deceased34Eloped34Home34Left Without Being Treated/Seen34Patient Name Entered in Error34Sent to Nurse Eval / Drop-in Clinic34Sent to Urgent Care Clinic34Transferred to a Non-VA Facility35Transferred to VA Facility35Disposition view8, 33Entering free-text diagnoses38Entering ICD-9-CM diagnoses38Removing patients from the board39Removing patients who were entered in error40Selecting a disposition34Selecting a reason for delay35ED BVAC Patients report51EDIS and CPRS interactions10EDIS integration via Appointment Manager11EDIS integration via PCE12Edit Closed view8, 41Emergency Severity IndexESI28Entering free-text diagnoses38Entering ICD-9-CM diagnoses38Exporting reports60Exposure report52General instructions for configuring colors70Help files10Identify patients21Including residents on the entry form80Integrating via Appointment Manager10Integrating via PCE10JAWS (Job Access with SpeechRecommendations for JAWS users2JAWS (Job Access with Speech)2Launch EDIS7Log in7Long complaint entries28Missed Opportunities report53NotificationsSee also: AlertsDuplicate patient selection warning16Multiple patient icon16Patient record flags15Patient selection messages15Nurse entries28Orders by Acuity report54Parameters subview, configure viewIncluding residents on the entry form80Parameters subview, Configure view79Configuring shift parameters81Requiring a disposition to remove patients from the board81Requiring a reason for delay81Requiring diagnoses80Requiring ICD-9-CM or free-text diagnoses80Saving parameter selections81Setting a default room or area81Setting a default room or area for patients arriving by ambulance81Patient Intake report54PC-based Display Board view43Viewing the PC-based display board43Preventing EDIS from accidentally closing5Printing reports60Provider entries28Provider report57Rehabilitation Act of 1973 (Section 508)Job Access with Speech (JAWS)2Removing display-board columns68Removing patients from the board39Removing patients who were entered in error40Removing providers, residents, and nurses from staff pick lists46Reports v iewAcuity report (standard)49Reports view9, 47Activity report (standard)48Column headings for reports47Cross Reference (XRef) report (restricted)57Delay report (standard)50Delay Summary report (standard)51Disposition abbreviations for reports47ED BVAC Patients report (standard)51Exporting reports (restricted action)60Exposure report (standard)52Missed Opportunities report (standard)53Orders by Acuity report (standard)54Patient Intake report (standard)54Printing reports60Provider report (restricted)57Running and viewing reports59Shift report55VA Admissions report (standard)56RequirementsBrowser requirements for Flash Player3Flash Player minimum requirements for Apple Mac OS4Job Access with Speech workstation requirements4Workstation3Requiring a disposition to remove patients from the board81Requiring a reason for delay81Requiring diagnoses80Requiring ICD-9-CM or free-text diagnoses80Resident entries28Resize columns9Resizing display-board columns68Restricted record warning15Role-based accessSee ViewsRoom / Area subview, Configure view61Adding, configuring, and editing rooms and areas61Configuring colors for rooms and areas63Specifying the order of rooms and areas63Room and area entries28Running and viewing reports59Saving display-board configurations69Saving parameter selections81Selecting a disposition34Selecting a reason for delay35Selecting views9Selections subview, Configure view82Adding status, disposition, delay reason, and source selections to selection lists84Setting a default room or area81Setting a default room or area for patients arriving by ambulance81Setting patients' primary providers32Shift report55Sign In view8, 17Add patients17Sort columns10Source entries29Specifying the order of rooms and areas63Status entries28Triage view8, 23Add triage information28Creating visits in CPRS29Update view8, 31Add update information31Creating a visit in CPRS32Setting patients' primary providers32VA Admissions report56Verify code (change)8Views8Assign Staff9Configure9Display Board8Disposition8Edit Closed8Reports9Sign In8Triage8Update8Workstation requirements3 ................
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